Individual
THOMAS D MAGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 LEGACY PLZ W, LA PORTE, IN 46350-5296
(219) 861-8161
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01042440A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100383750
—
IN
Enumeration date
08/07/2006
Last updated
03/07/2024
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