Provider Demographics
NPI:1588087290
Name:MCGINLEY, MARTIN D
Entity type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:D
Last Name:MCGINLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DONHAM PLZ FL 4
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-1932
Mailing Address - Country:US
Mailing Address - Phone:513-423-0781
Mailing Address - Fax:
Practice Address - Street 1:601 N BREIEL BLVD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-3801
Practice Address - Country:US
Practice Address - Phone:513-420-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP475103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool