Organization
GARY S MCCOY DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY STEVEN MCCOY DPM PA (PRESIDENT)
(904) 262-7087
Entity
Organization
Contact information
Practice address
9765 SAN JOSE BLVD, SUITE 104, JACKSONVILLE, FL 32257-4402
(904) 262-7087
(904) 262-7215
Mailing address
9765 SAN JOSE BLVD, SUITE 104, JACKSONVILLE, FL 32257-4402
(904) 262-7087
(904) 262-7215
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PO1996
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040679100
—
FL
01
—
480030592
RAILROAD MEDICARE
FL
Enumeration date
12/06/2007
Last updated
07/23/2010
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