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Organization
UNIVERSITY SPORTS MEDICINE PC
Active
Organization
UNIVERSITY SPORTS MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER LESLIE MCCOY M.D. (PRESIDENT)
(480) 222-3384
Entity
Organization
Contact information
Practice address
15810 S 45TH ST STE 101, PHOENIX, AZ 85048-7695
(480) 222-3384
(480) 222-3422
Mailing address
15810 S 45TH ST STE 101, PHOENIX, AZ 85048-7695
(480) 222-3384
(480) 222-3422
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
22472
AZ
Other
Enumeration date
07/10/2006
Last updated
08/23/2007
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