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General NPI Number Information
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NPI Number | 1639174659
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Entity Type | Individual
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Provider Name | JOHN D MCGARRY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 168 INDUSTRIAL DR MEDICAL VILLAGE ANNEX BUILDING
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City | FESTUS
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State | MO
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Zip | 63028-4133
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Country | US
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Telephone | 636-937-0005
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Fax | 636-933-9494
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Provider Business Mailing Address
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Address Line | P O BOX 470
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City | CRYSTAL CITY
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State | MO
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Zip | 63019-0470
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Country | US
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Telephone | 636-937-0005
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Fax | 636-933-9494
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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 | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number | 35835
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 35835
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License Number State | MO
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