Provider Demographics
NPI:1366264103
Name:MCGILTON, LONNIE
Entity type:Individual
Prefix:
First Name:LONNIE
Middle Name:
Last Name:MCGILTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 1ST ST
Mailing Address - Street 2:
Mailing Address - City:INWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:25428-4008
Mailing Address - Country:US
Mailing Address - Phone:304-433-7082
Mailing Address - Fax:
Practice Address - Street 1:272 1ST ST
Practice Address - Street 2:
Practice Address - City:INWOOD
Practice Address - State:WV
Practice Address - Zip Code:25428-4008
Practice Address - Country:US
Practice Address - Phone:304-433-7082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide