Basic Information
Provider Information
NPI: 1427094853
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGUIRE
FirstName: JOHN
MiddleName: FRANCIS
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 658
Address2:  
City: GAINESVILLE
State: GA
PostalCode: 305030658
CountryCode: US
TelephoneNumber: 7707181122
FaxNumber: 7705348998
Practice Location
Address1: 725 JESSE JEWELL PKWY SE
Address2:  
City: GAINESVILLE
State: GA
PostalCode: 305013834
CountryCode: US
TelephoneNumber: 7702972200
FaxNumber: 7705348139
Other Information
ProviderEnumerationDate: 06/22/2006
LastUpdateDate: 08/31/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000XRN053124GAY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

ID Information
IDTypeStateIssuerDescription
000340414J05GA MEDICAID
000340414K05GA MEDICAID
000340414C05GA MEDICAID
1004550801GAAMERIGROUPOTHER
34087401GAWELLCAREOTHER
000340414L05GA MEDICAID


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