Provider Demographics
NPI:1487949483
Name:MCCARTY, BRENT VAN (MD)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:VAN
Last Name:MCCARTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 PINNACLE PKWY
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-9167
Mailing Address - Country:US
Mailing Address - Phone:985-674-1700
Mailing Address - Fax:985-273-3322
Practice Address - Street 1:1200 PINNACLE PKWY
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-9167
Practice Address - Country:US
Practice Address - Phone:985-674-1700
Practice Address - Fax:985-273-3322
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.205933207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty