1497029912 NPI number — RONALD C. MCCOY, M.D., PA

Table of content: (NPI 1497029912)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497029912 NPI number — RONALD C. MCCOY, M.D., PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RONALD C. MCCOY, M.D., PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497029912
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/01/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O BOX 1224
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BESSEMER
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-426-6381
Provider Business Mailing Address Fax Number:
205-426-6385

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 SECOND AVENUE NORTH
Provider Second Line Business Practice Location Address:
RONALD C. MCCOY,M.D.,PA
Provider Business Practice Location Address City Name:
BESSEMER
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35020-4836
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-426-6381
Provider Business Practice Location Address Fax Number:
205-426-6385
Provider Enumeration Date:
03/01/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MCCOY
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
205-426-6381

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  6265 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000004143 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com