Provider Demographics
NPI:1407735186
Name:MCPHAIL, TY MATTHEW
Entity type:Individual
Prefix:
First Name:TY
Middle Name:MATTHEW
Last Name:MCPHAIL
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 1:304 W RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3153
Mailing Address - Country:US
Mailing Address - Phone:316-680-5230
Mailing Address - Fax:316-680-5230
Practice Address - Street 1:304 W RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3153
Practice Address - Country:US
Practice Address - Phone:316-680-5230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program