Provider Demographics
NPI:1487494738
Name:MCCARTY, JAMES CAROL III
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:CAROL
Last Name:MCCARTY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 HELMSDALE PL APT 8102
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2462
Mailing Address - Country:US
Mailing Address - Phone:859-585-9078
Mailing Address - Fax:
Practice Address - Street 1:3050 HELMSDALE PL APT 8102
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2462
Practice Address - Country:US
Practice Address - Phone:859-585-9078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer