Provider Demographics
NPI:1588104335
Name:TIMOTHY G. MCGARRY, MD, PLLC
Entity type:Organization
Organization Name:TIMOTHY G. MCGARRY, MD, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:G
Authorized Official - Last Name:MCGARRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-525-4377
Mailing Address - Street 1:21371 FORSYTHE RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24202-4357
Mailing Address - Country:US
Mailing Address - Phone:276-525-4377
Mailing Address - Fax:276-525-4378
Practice Address - Street 1:21371 FORSYTHE RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24202
Practice Address - Country:US
Practice Address - Phone:276-525-4377
Practice Address - Fax:276-525-4378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101048147207X00000X, 207X00000X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty