Individual
DR. ROBERT N MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 BUCKNER ST, SUITE C120, SHREVEPORT, LA 71101-4440
(318) 227-8899
(318) 222-0407
Mailing address
1800 BUCKNER ST, SUITE C120, SHREVEPORT, LA 71101-4440
(318) 227-8899
(318) 222-0407
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
05128R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
053664101
TEXAS MEDICAID
TX
05
—
1313548
—
LA
01
—
3100064
UNITER HEALTHCARE
—
01
—
390005505
RAILROAD MEDICARE
LA
01
—
721404303MC1
OCHSNER
—
01
—
A007
CHAMPUS
—
Enumeration date
09/29/2005
Last updated
07/01/2010
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