Healthcare Provider Details

I. General information

NPI: 1477662179
Provider Name (Legal Business Name): JOHN F MCCARTHY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PROGRESS POINT PKWY STE 202
O FALLON MO
63368-2207
US

IV. Provider business mailing address

12855 N 40 DR STE 375
SAINT LOUIS MO
63141-8657
US

V. Phone/Fax

Practice location:
  • Phone: 636-216-8372
  • Fax: 314-741-5102
Mailing address:
  • Phone: 314-567-6071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number106421
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number036107987
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: