MEDICARE: MR. GARY LYNN MCAFOOS 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	208600000X	Surgery Physician	MD032638E	PA

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
2	MC159174	OTHER	PA	HIGHMARK BLUE SHIELD
3	00051423001	OTHER	NY	UNIVERA

General Provider Information

NPI Number	:	1609870641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GARY LYNN MCAFOOS MD

Provider Business Mailing Address
First Line	:	103 W SAINT CLAIR ST
Second Line	:	RM 2D
City	:	WARREN
State	:	PA
Zip	:	16365-2188
Country	:	US
Telephone Number	:	814-723-2770
Fax Number	:	814-723-0787

Provider Business Practice Location Address
First Line	:	103 W SAINT CLAIR ST
Second Line	:	RM 2D
City	:	WARREN
State	:	PA
Zip	:	16365-2188
Country	:	US
Telephone Number	:	814-723-2770
Fax Number	:	814-723-0787

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	07/08/2007

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