| Paul Carpenter Maccarty I, | |
|
4157 River Rd, South Boston, VA 24592-6017 | |
| (434) 572-7908 | |
| Not Available |
| Full Name | Paul Carpenter Maccarty I |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 5 Years |
| Location | 4157 River Rd, South Boston, Virginia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649840208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 0110008116 (Virginia) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (NU) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Centra Health, Inc | Lynchburg, VA | Hospital |
| Southside Community Hospital, Inc | Farmville, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Centra Medical Group Llc | 4789606088 | 709 |
| Entity Name | Centra Medical Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649228966 PECOS PAC ID: 4789606088 Enrollment ID: O20051230000147 |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Carpenter Maccarty I, 4157 River Rd, South Boston, VA 24592-6017 Ph: (434) 572-7908 | Paul Carpenter Maccarty I, 4157 River Rd, South Boston, VA 24592-6017 Ph: (434) 572-7908 |
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