Provider Demographics
NPI:1396922514
Name:DR. RICHARD N. MCCARTY, INC.
Entity type:Organization
Organization Name:DR. RICHARD N. MCCARTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:MCCARTY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-836-3711
Mailing Address - Street 1:495 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GROVEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43125-1184
Mailing Address - Country:US
Mailing Address - Phone:614-836-3711
Mailing Address - Fax:614-836-0020
Practice Address - Street 1:495 MAIN ST
Practice Address - Street 2:
Practice Address - City:GROVEPORT
Practice Address - State:OH
Practice Address - Zip Code:43125-1184
Practice Address - Country:US
Practice Address - Phone:614-836-3711
Practice Address - Fax:614-836-0020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2497207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9166822Medicare PIN