Provider Demographics
NPI:1821208836
Name:DAVID L. MCGAREY MD PC
Entity Type:Organization
Organization Name:DAVID L. MCGAREY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LESTER
Authorized Official - Last Name:MCGAREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-779-0500
Mailing Address - Street 1:4800 N 22ND ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4701
Mailing Address - Country:US
Mailing Address - Phone:602-955-1000
Mailing Address - Fax:602-508-4830
Practice Address - Street 1:1030 N SAN FRANCISCO ST
Practice Address - Street 2:SUITE 130
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3252
Practice Address - Country:US
Practice Address - Phone:928-779-0500
Practice Address - Fax:928-779-6350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25297174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ61925Medicare ID - Type Unspecified
AZ1259540001Medicare NSC