Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | G52009 | CA |
NPI | 1013019082 |
---|---|
Provider Name | Joseph Wesley Mccoy JR. |
First Address | Napa, CA 94558-2900 |
Second Address | Napa, CA 94558-2900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 18/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F07966 | (02) | CA |