Provider Demographics
NPI:1487632188
Name:MCCARTY, RICHMOND DOW (DO)
Entity type:Individual
Prefix:DR
First Name:RICHMOND
Middle Name:DOW
Last Name:MCCARTY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 MOBILE ST
Mailing Address - Street 2:
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-6801
Mailing Address - Country:US
Mailing Address - Phone:662-869-2122
Mailing Address - Fax:662-869-1367
Practice Address - Street 1:353 MOBILE ST
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-6801
Practice Address - Country:US
Practice Address - Phone:662-869-2122
Practice Address - Fax:662-869-1367
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19101208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02022531Medicaid
MS02022531Medicaid