MEDICARE: JOHN D MCGARRY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P0004X	Spinal Cord Injury Medicine Physician	35835	MO
2	2084N0400X	Neurology Physician	35835	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	130001044	OTHER	MO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0500010	OTHER	MO	UNITED HEALTHCARE
4	3008	OTHER	MO	BLUE SHIELD
5	116562	OTHER	MO	HEALTHLINK
6	4311996	OTHER	MO	AETNA

General Provider Information

NPI Number	:	1639174659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN D MCGARRY M.D.

Provider Business Mailing Address
First Line	:	P O BOX 470
Second Line	:
City	:	CRYSTAL CITY
State	:	MO
Zip	:	63019-0470
Country	:	US
Telephone Number	:	636-937-0005
Fax Number	:	636-933-9494

Provider Business Practice Location Address
First Line	:	168 INDUSTRIAL DR
Second Line	:	MEDICAL VILLAGE ANNEX BUILDING
City	:	FESTUS
State	:	MO
Zip	:	63028-4133
Country	:	US
Telephone Number	:	636-937-0005
Fax Number	:	636-933-9494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	02/05/2014

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Directions to “ JOHN D MCGARRY M.D.” Practice Location

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