Provider Demographics
NPI:1437342516
Name:MCCRORY, GARY WILLIAM (DPT)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:WILLIAM
Last Name:MCCRORY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 OLD CANTON RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-8669
Mailing Address - Country:US
Mailing Address - Phone:601-856-8041
Mailing Address - Fax:866-404-9501
Practice Address - Street 1:7521 OLD CANTON RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-8669
Practice Address - Country:US
Practice Address - Phone:601-856-8041
Practice Address - Fax:866-404-9501
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT3362225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist