Provider Demographics
NPI:1497869531
Name:MCCARTY, FOSTER TIMM (DO)
Entity Type:Individual
Prefix:MR
First Name:FOSTER
Middle Name:TIMM
Last Name:MCCARTY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7555 E OSBORN RD STE 104
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6468
Mailing Address - Country:US
Mailing Address - Phone:480-947-5454
Mailing Address - Fax:
Practice Address - Street 1:7555 E OSBORN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6434
Practice Address - Country:US
Practice Address - Phone:480-947-5454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ855207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ257099Medicaid
AZ257099Medicaid