Provider Demographics
NPI:1558370395
Name:MCCARTHY, BRIAN E (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:E
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3570 STROLLING WAY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-3767
Mailing Address - Country:US
Mailing Address - Phone:352-238-4237
Mailing Address - Fax:850-942-0090
Practice Address - Street 1:2858 MAHAN DR STE 1&2
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5446
Practice Address - Country:US
Practice Address - Phone:850-942-0096
Practice Address - Fax:850-942-0090
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2298213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPO2298OtherLICENSE
FL65276OtherBLUE CROSS/BLUE SHIELD OF
FL65276OtherBLUE CROSS/BLUE SHIELD OF