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General NPI Number Information
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NPI Number | 1346395274
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Entity Type | Individual
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Provider Name | MICHAEL EUGENE MCCARTY O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 12/21/2009
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Provider Practice Location Address
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Address Line | 1016 W POPLAR AVE STE 112
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City | COLLIERVILLE
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State | TN
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Zip | 38017-2687
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Country | US
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Telephone | 901-360-1213
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Fax |
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Provider Business Mailing Address
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Address Line | 5121 PEAR DR
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City | SOUTHAVEN
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State | MS
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Zip | 38671-9325
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Country | US
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Telephone | 662-349-3772
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 764
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License Number State | TN
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