Provider Demographics
NPI:1760687735
Name:MCCARTY, CRAIG WILLARD (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:WILLARD
Last Name:MCCARTY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:CO
Mailing Address - Zip Code:80734-1854
Mailing Address - Country:US
Mailing Address - Phone:970-854-2500
Mailing Address - Fax:970-854-3440
Practice Address - Street 1:1001 E JOHNSON ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:CO
Practice Address - Zip Code:80734-1854
Practice Address - Country:US
Practice Address - Phone:970-854-2500
Practice Address - Fax:970-854-3440
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY7686A207Q00000X
CODR.0056305207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine