Mccoy, Gary S

Mccoy, Gary S is an individual health care provider with primary practice located at 9765 San Jose Blvd Suite 104, Jacksonville FL 32257-4402. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Mccoy, Gary S can be contacted via phone (904) 262-7087.

Contact Information

Primary practice address
9765 San Jose Blvd Suite 104 Jacksonville FL 32257-4402
Phone: (904) 262-7087
Fax: (904) 262-7215
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO1996 Florida

Profile Details

NPI number 1245200039
LBN Legal business name Mccoy, Gary S
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Jul 23rd, 2010 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245200039 NPPES
Florida Other 59-3516897 TAX ID
Florida MEDICAID 040679100 TAX ID
Florida Other 480030592 TAX ID

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