Individual
ROBERT MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
901 S 5TH AVE, MADILL, OK 73446-3640
(580) 795-3384
(580) 795-0185
Mailing address
901 S 5TH AVE, MADILL, OK 73446-3640
(580) 795-3384
(580) 795-0185
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R0025463
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100788730AS
—
OK
Enumeration date
06/22/2006
Last updated
09/15/2014
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