Male or Other

Joseph Mcilvaine PA-C

Medical Physician Assistant in Offutt Afb, NE(View on Map)

Full Name

Joseph Mcilvaine PA-C

NPI Number

1871097717

NPI Type

Individual Provider

Gender

Male

Enumeration Date

03/23/2018

Specialties

(Taxonomies)

Code

363AM0700X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

2501 CAPEHART RD
2501 CAPEHART RD

City

Offutt Afb
Offutt Afb

State

NE
NE

Postal Code

68113-1043
68113-1043

Country

US
US

Telephone Number

N/A
(318) 456-2380

Identifiers

Identifier

1871097717

Identifier State

NV

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/02/2022

Provider Address

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Female

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