Garry W Magouirk MDPC

Organization Active NPI Family Medicine Physician · Fayette, AL

NPI 1922029263 · NPPES record last updated Feb 15, 2013

Key facts

NPI
1922029263
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
00010435 (AL)
Legal business name
GARRY W MAGOUIRK MDPC
Practice address
110 23Rd St NW
Fayette, AL 35555-1001
Phone
(205) 932-3891
Fax
(205) 932-3996
NPI assigned
Jul 22, 2006
Organization subpart
No

Authorized official

Name
Garry W Magouirk, MD
Title
President/Ceo
Phone
(205) 932-3891

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20051103001207 AL Part B Supplier - Clinic/Group Practice 8628096047 Receives reassigned benefits from 6 practitioners
Practice locations: Fayette, AL

National Provider Directory

Locations

110 23rd St NW
Fayette, AL 35555
Phone (205) 932-3891

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 00010435 AL Yes

Addresses

Primary practice location

110 23Rd St NW
Fayette, AL 35555-1001

Mailing address

110 23Rd St NW
Fayette, AL 35555-1001
Phone (205) 932-3891

Other providers in Fayette, AL

All providers in Fayette, AL · Family Medicine Physician in Alabama

Sources for this page

Verify at the official NPI Registry.