Mccoy, Justin

Mccoy, Justin is an individual health care provider with primary practice located at 777 N Raymond St , Boise ID 83704-9251. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Mccoy, Justin can be contacted via phone (208) 514-2500.

Contact Information

Primary practice address
777 N Raymond St Boise ID 83704-9251
Phone: (208) 514-2500
Fax: (208) 375-2217
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X O-0857 Idaho
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X DR.0057008 Colorado

Profile Details

NPI number 1265792238
LBN Legal business name Mccoy, Justin
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2012
Last updated May 25th, 2023 - about 2 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 1265792238 NPPES
Idaho MEDICAID 1265792238

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