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1275537078

NPI Code Detail

MEDICARE: DR. EMMA E.K. MCCARTY MD

MEDICARE: DR. EMMA E.K. MCCARTY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	13626R	LA
2	208000000X	Pediatrics Physician	13626R	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	414798YLMV	OTHER	CO	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275537078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMMA E.K. MCCARTY MD

Provider Business Mailing Address
First Line	:	2750 BROADWAY ST
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-3573
Country	:	US
Telephone Number	:	303-440-3122
Fax Number	:	303-440-3282

Provider Business Practice Location Address
First Line	:	2750 BROADWAY ST
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80304-3573
Country	:	US
Telephone Number	:	303-440-3122
Fax Number	:	303-440-3282

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	08/19/2016

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Directions to “ DR. EMMA E.K. MCCARTY MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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