Individual
DR. PATRICIA MASSENGILL MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 PROVIDENCE MAIN ST NW, 2ND FLOOR STE 1E, HUNTSVILLE, AL 35806-4826
(256) 382-2700
Mailing address
100 A PROVIDENCE MAIN STREET, SUITE 1E, HUNTSVILLE, AL 35806-5230
(256) 382-2700
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
00017039
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000009396
MEDICARE PTAN
AL
05
—
000009396
—
AL
01
—
051009396
BLUE CROSS BLUE SHIELD
AL
01
—
180036882
RAILROAD MEDICARE
—
Enumeration date
11/23/2005
Last updated
05/13/2021
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