Individual
JOHN SCOTT MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6333 E SKELLY DR, TULSA, OK 74135-6106
(918) 779-1085
Mailing address
1200 E 146TH ST S, GLENPOOL, OK 74033-3799
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053317883
SUBSTANCE ABUSE TREATMENT FACILITY
—
05
—
1053317883
—
OK
Enumeration date
11/08/2017
Last updated
06/16/2018
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