Provider Demographics
NPI:1164419966
Name:MCGARRY, JOSEPH T (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:T
Last Name:MCGARRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:CO
Mailing Address - Zip Code:81226-1126
Mailing Address - Country:US
Mailing Address - Phone:719-784-4816
Mailing Address - Fax:
Practice Address - Street 1:501 W 5TH ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:CO
Practice Address - Zip Code:81226-1126
Practice Address - Country:US
Practice Address - Phone:719-784-4816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21028207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01210285Medicaid
COD23866Medicare UPIN
COC61021Medicare ID - Type Unspecified