Individual
JASON ROBERT MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
110 N 66TH ST, LINCOLN, NE 68505-2402
(402) 325-8950
Mailing address
110 N 66TH ST, LINCOLN, NE 68505-2402
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1594
NE
363AM0700X
Medical Physician Assistant
1501483
KS
Other
Enumeration date
12/20/2007
Last updated
01/08/2023
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