Individual
MR. KEVIN JOHN MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
SIDNEY AND LAMONT ST, MOUNTAIN HOME, TN 37684
(423) 926-1171
Mailing address
1309 ROCKY HOLLOW RD, JONESBOROUGH, TN 37659-5004
(423) 753-8678
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
477
TN
Other
Enumeration date
07/10/2006
Last updated
07/08/2007
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