# GLENN A. MCCOY, MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588841308
- **Authorized official:** DR. GLENN A MCCOY M.D. (PRESIDENT)
- **Authorized official phone:** (502) 368-3056

## Contact information

- **Practice address:** 1700 BLUEGRASS AVENUE, SUITE 110, LOUISVILLE, KY 40215-1129
- **Practice address phone:** (502) 368-3056
- **Practice address fax:** (502) 363-1627
- **Mailing address:** 1700 BLUEGRASS AVENUE, SUITE 110, LOUISVILLE, KY 40215
- **Mailing address phone:** (502) 368-3056
- **Mailing address fax:** (502) 363-1627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 23946 | KY | Yes |

## Other

- **Enumeration date:** 01/23/2008
- **Last updated:** 11/05/2010