Provider Demographics
NPI:1588634067
Name:MCCARTHY, THOMAS T (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:T
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4105 BRIARGATE PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3480
Mailing Address - Country:US
Mailing Address - Phone:719-473-3332
Mailing Address - Fax:719-368-6870
Practice Address - Street 1:4105 BRIARGATE PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3480
Practice Address - Country:US
Practice Address - Phone:719-473-3332
Practice Address - Fax:719-368-6870
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COCO20003207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01200039Medicaid
E06387Medicare UPIN
COCR7898Medicare PIN