Provider Demographics
NPI:1316912454
Name:MCCARTHY, JOHN J III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:MCCARTHY
Suffix:III
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 1:5208 MONTICELLO AVE
Mailing Address - Street 2:SUITE 180
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-8212
Mailing Address - Country:US
Mailing Address - Phone:757-206-4001
Mailing Address - Fax:757-645-3965
Practice Address - Street 1:5208 MONTICELLO AVE
Practice Address - Street 2:SUITE 180
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-8212
Practice Address - Country:US
Practice Address - Phone:757-206-4001
Practice Address - Fax:757-645-3965
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232270207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010018234Medicaid
VA010018234Medicaid
002803S33Medicare ID - Type Unspecified