Mccoy, Clark Steven
Mccoy, Clark Steven is an individual health care provider with primary practice located at 1120 E Elizabeth St Ste 2 , Fort Collins CO 80524-4044. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Mccoy, Clark Steven can be contacted via phone (970) 493-9193.Contact Information
Primary practice address
1120 E Elizabeth St Ste 2
Fort Collins CO 80524-4044
Phone: (970) 493-9193
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | CDRH.0054001 | Colorado |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD2019-0018 | New Mexico |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | MD2019-0018 | New Mexico |
Profile Details
| NPI number | 1871517912 |
|---|---|
| LBN Legal business name | Mccoy, Clark Steven |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 26th, 2006 |
| Last updated | Dec 12th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871517912 | NPPES |
| Other | 258651 | AVMED | |
| Other | 31540 | AVMED | |
| MEDICAID | 250902400 | AVMED | |
| MEDICAID | 19505523 | AVMED |
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