Provider Demographics
NPI:1922195841
Name:MCCARTHY, GEOFFREY WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:WILLIAM
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 NW MELINDA AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-3126
Mailing Address - Country:US
Mailing Address - Phone:503-241-8468
Mailing Address - Fax:
Practice Address - Street 1:677 NW MELINDA AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3126
Practice Address - Country:US
Practice Address - Phone:503-241-8468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK26847207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine