Provider Demographics
NPI:1962690453
Name:MCGINLEY, JOSEPH C (MD, PHD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:MCGINLEY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 S CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-6244
Mailing Address - Country:US
Mailing Address - Phone:215-847-1462
Mailing Address - Fax:
Practice Address - Street 1:234 E 1ST ST STE 230
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2516
Practice Address - Country:US
Practice Address - Phone:866-678-4699
Practice Address - Fax:833-992-2034
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA922242085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A869820Medicaid
CA00A869820OtherMEDICARE
CAI13678Medicare UPIN