Provider Demographics
NPI:1245225465
Name:MCGARRY, TIMOTHY G (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:G
Last Name:MCGARRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:TIMOTHY
Other - Middle Name:G
Other - Last Name:MCGARRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:21371 FORSYTHE RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24202-4357
Mailing Address - Country:US
Mailing Address - Phone:276-525-4377
Mailing Address - Fax:276-525-4378
Practice Address - Street 1:21371 FORSYTHE RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24202-4357
Practice Address - Country:US
Practice Address - Phone:276-525-4377
Practice Address - Fax:276-525-4378
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-048147207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF30740Medicare UPIN
014536A49Medicare PIN