Provider Demographics
NPI:1386705929
Name:MCCARTY, THOMAS A JR
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:MCCARTY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 241185
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99524-1185
Mailing Address - Country:US
Mailing Address - Phone:907-278-6400
Mailing Address - Fax:907-278-6928
Practice Address - Street 1:3500 LATOUCHE ST STE 310
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4261
Practice Address - Country:US
Practice Address - Phone:907-278-6400
Practice Address - Fax:907-278-6928
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2008-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKAU0176Medicaid
AKK0000VGBHDMedicare ID - Type UnspecifiedAK MEDICARE
AKAU0176Medicaid