Provider Demographics
NPI:1063776532
Name:MCCARTY, JOHN THOMAS (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:THOMAS
Last Name:MCCARTY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N STATE ST
Mailing Address - Street 2:DEPT. OF RADIOLOGY
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:601-984-2695
Mailing Address - Fax:601-984-2683
Practice Address - Street 1:2006 FRANKLIN ST SE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4537
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18462085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL248220Medicaid
AL249743Medicaid
AL215999Medicaid
AL215707Medicaid
AL216707Medicaid
AL225770Medicaid
AL248542Medicaid
AL249761Medicaid
AL215938Medicaid
AL239874Medicaid
AL247997Medicaid
AL215994Medicaid
AL216709Medicaid
AL249586Medicaid