Provider Demographics
NPI:1689611287
Name:MCCARTHY, TROY SCOTT (PA-C)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:SCOTT
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:425 ELM ST N
Mailing Address - Street 2:CENTRACARE HEALTH SYSTEM - SAUK CENTRE
Mailing Address - City:SAUK CENTRE
Mailing Address - State:MN
Mailing Address - Zip Code:56378-1010
Mailing Address - Country:US
Mailing Address - Phone:320-352-2221
Mailing Address - Fax:320-352-1740
Practice Address - Street 1:425 ELM ST N
Practice Address - Street 2:CENTRACARE HEALTH SYSTEM - SAUK CENTRE
Practice Address - City:SAUK CENTRE
Practice Address - State:MN
Practice Address - Zip Code:56378-1010
Practice Address - Country:US
Practice Address - Phone:320-352-2221
Practice Address - Fax:320-352-1740
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN11072363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN970006851Medicare PIN
AZP94479Medicare UPIN