=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922174283
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MICHAEL R MCCARTNEY DC PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/28/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10752 NO 89TH PLACE SUITE 228
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85260-6745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-661-1977
-----------------------------------------------------
Fax | 480-767-0761
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10752 NO 89TH PLACE SUITE 228
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85260-6745
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-661-1977
-----------------------------------------------------
Fax | 480-767-0761
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER PRESIDENT CEO
-----------------------------------------------------
Name | DR. MICHAEL ROWELL MCCARTNEY
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 480-661-1977
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 5262
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------