Provider Demographics
NPI:1881893162
Name:CATHLEEN A MCCARTHY DPM PLLC
Entity type:Organization
Organization Name:CATHLEEN A MCCARTHY DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHLEEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:480-563-5115
Mailing Address - Street 1:7450 E PINNACLE PEAK RD
Mailing Address - Street 2:STE 156
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3435
Mailing Address - Country:US
Mailing Address - Phone:480-563-5115
Mailing Address - Fax:480-563-5132
Practice Address - Street 1:7450 E PINNACLE PEAK RD
Practice Address - Street 2:STE 156
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3435
Practice Address - Country:US
Practice Address - Phone:480-563-5115
Practice Address - Fax:480-563-5132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0644213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ117696Medicare PIN
AZ4392370001Medicare NSC