Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 192 | AR |
N | 222Z00000X | Podiatrist | 192 | AR |
N | 213ES0131X | Foot Surgery | 192 | AR |
NPI | 1194737023 |
---|---|
Provider Name | Dr. Sara Mccoy |
First Address | Fayetteville, AR 72703-1944 |
Second Address | Fayetteville, AR 72703-1944 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 08/07/2007 |