Basic Information
Provider Information
NPI: 1053332882
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGEE
FirstName: HUGH
MiddleName: WILLIAM
NamePrefix: MR.
NameSuffix: JR.
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11240 WAPLES MILL RD
Address2: STE 403
City: FAIRFAX
State: VA
PostalCode: 22030
CountryCode: US
TelephoneNumber: 7033854707
FaxNumber: 7036914933
Practice Location
Address1: 1850 TOWN CENTER PKWY
Address2: 403
City: RESTON
State: VA
PostalCode: 20190
CountryCode: US
TelephoneNumber: 7037362806
FaxNumber: 7037361677
Other Information
ProviderEnumerationDate: 07/21/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X2305202172VAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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