Provider Demographics
NPI:1568566719
Name:MCPHAIL, JOHN STEVE (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STEVE
Last Name:MCPHAIL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:479 HEYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-1726
Mailing Address - Country:US
Mailing Address - Phone:864-583-6381
Mailing Address - Fax:864-583-6390
Practice Address - Street 1:1520 BOILING SPRINGS RD
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:SC
Practice Address - Zip Code:29316
Practice Address - Country:US
Practice Address - Phone:864-583-6381
Practice Address - Fax:864-583-6390
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1083152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU77744-0281OtherINDIVIDUAL PTAN
SC1083OtherOPTOMETRIST LICENSE
SC1457384729OtherGROUP NPI
SCD10833Medicaid
SCU77744-7292OtherGROUP PTAN
SC1568566719OtherINDIVIDUAL NPI