Healthcare Provider Details

I. General information

NPI: 1720043110
Provider Name (Legal Business Name): CHRIS MCGARY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 07/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 S LANDMARK AVE
BLOOMINGTON IN
47403-5003
US

IV. Provider business mailing address

PO BOX 4366
BLOOMINGTON IN
47402-4366
US

V. Phone/Fax

Practice location:
  • Phone: 812-332-8242
  • Fax: 812-333-7684
Mailing address:
  • Phone: 812-332-8242
  • Fax: 812-333-7684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number01058619A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: