Provider Demographics
NPI:1326224056
Name:MCGARRY, JONATHON HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHON
Middle Name:HOWARD
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 1:4525 DEAN MARTIN DR UNIT 1407
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-8113
Mailing Address - Country:US
Mailing Address - Phone:310-406-5189
Mailing Address - Fax:
Practice Address - Street 1:14721 WHITECAP BLVD APT 346
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-7723
Practice Address - Country:US
Practice Address - Phone:310-406-5189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2014-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96955207P00000X
MN107830207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH400179635Medicare PIN
MNH400179638Medicare PIN