MEDICARE: REBECCA A. MCCARTHY MD

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	207N00000X	Dermatology Physician	K7452	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	00909U	OTHER		MEDICARE GROUP NUMBER
4	P00004304	OTHER		RAILROAD MEDICARE NUMBER

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770581464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA A. MCCARTHY MD

Provider Business Mailing Address
First Line	:	4512 VAN WINKLE DR
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79119
Country	:	US
Telephone Number	:	806-358-1497
Fax Number	:	806-358-1375

Provider Business Practice Location Address
First Line	:	4512 VAN WINKLE DR
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79119
Country	:	US
Telephone Number	:	806-358-1497
Fax Number	:	806-358-1375

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	05/27/2010

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Directions to “ REBECCA A. MCCARTHY MD” Practice Location

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