Provider Demographics
NPI:1174518930
Name:MACPHAIL, JOHN ADAM (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ADAM
Last Name:MACPHAIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 S PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-2262
Mailing Address - Country:US
Mailing Address - Phone:814-445-3575
Mailing Address - Fax:814-445-5700
Practice Address - Street 1:126 E CHURCH ST STE 2100
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2271
Practice Address - Country:US
Practice Address - Phone:814-445-1281
Practice Address - Fax:814-443-3214
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2018-01-17
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
NC2009-02130207X00000X
PAMD021853E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA002982424OtherHIGHMARK BLUE SHIELD
PA710929OtherMEDICARE
PA0015083500032Medicaid
PACI6140OtherRAILROAD MEDICARE