Provider Demographics
NPI:1063479947
Name:MCCARTHY, JOHN F (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
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 1:220 SPRING VALLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-2653
Mailing Address - Country:US
Mailing Address - Phone:937-436-3117
Mailing Address - Fax:937-436-0730
Practice Address - Street 1:220 E SPRING VALLEY PIKE
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-2653
Practice Address - Country:US
Practice Address - Phone:937-436-3117
Practice Address - Fax:937-436-0730
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3505579M207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0669343Medicaid
OH0641668Medicare PIN
OH0641661Medicare PIN
OH0641666Medicare PIN
OH0641665Medicare PIN
OH0669343Medicaid
080062509Medicare PIN
OH0641667Medicare PIN