MEDICARE: TROY SCOTT MCCARTHY PA-C

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	363A00000X	Physician Assistant	11072	MN

General Provider Information

NPI Number	:	1689611287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TROY SCOTT MCCARTHY PA-C

Provider Business Mailing Address
First Line	:	425 ELM ST N
Second Line	:	CENTRACARE HEALTH SYSTEM - SAUK CENTRE
City	:	SAUK CENTRE
State	:	MN
Zip	:	56378-1010
Country	:	US
Telephone Number	:	320-352-2221
Fax Number	:	320-352-1740

Provider Business Practice Location Address
First Line	:	425 ELM ST N
Second Line	:	CENTRACARE HEALTH SYSTEM - SAUK CENTRE
City	:	SAUK CENTRE
State	:	MN
Zip	:	56378-1010
Country	:	US
Telephone Number	:	320-352-2221
Fax Number	:	320-352-1740

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	08/01/2013

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