Provider Demographics
NPI:1992709729
Name:MAGILL, JOHN T III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:MAGILL
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:900 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-2800
Mailing Address - Country:US
Mailing Address - Phone:570-524-4446
Mailing Address - Fax:570-522-1110
Practice Address - Street 1:900 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-2800
Practice Address - Country:US
Practice Address - Phone:570-524-4446
Practice Address - Fax:570-522-1110
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023734E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA010167850009Medicaid
PAB40566Medicare UPIN
PA168938HCUMedicare ID - Type Unspecified