Provider Demographics
NPI:1427088707
Name:MCCARTY, LEWIS EARL JR (ATC, NREMT-I, OTC)
Entity type:Individual
Prefix:
First Name:LEWIS
Middle Name:EARL
Last Name:MCCARTY
Suffix:JR
Gender:M
Credentials:ATC, NREMT-I, OTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 OAK RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5018
Mailing Address - Country:US
Mailing Address - Phone:404-975-7933
Mailing Address - Fax:
Practice Address - Street 1:150 OAK RIDGE PL
Practice Address - Street 2:10 P
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5018
Practice Address - Country:US
Practice Address - Phone:404-975-7933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer