Provider Demographics
NPI:1952400756
Name:MACCARTY, WILLIAM C III (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:MACCARTY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 777
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-0777
Mailing Address - Country:US
Mailing Address - Phone:434-517-3590
Mailing Address - Fax:434-572-4549
Practice Address - Street 1:422 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-5200
Practice Address - Country:US
Practice Address - Phone:434-572-4074
Practice Address - Fax:434-572-4712
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101030114207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1952400756Medicaid
VA1952400756Medicaid