Provider Demographics
NPI:1013019082
Name:MCCOY, JOSEPH WESLEY JR (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:WESLEY
Last Name:MCCOY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1100 TRANCAS ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2900
Mailing Address - Country:US
Mailing Address - Phone:707-255-4113
Mailing Address - Fax:707-252-8452
Practice Address - Street 1:1100 TRANCAS ST
Practice Address - Street 2:SUITE 211
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2900
Practice Address - Country:US
Practice Address - Phone:707-255-4113
Practice Address - Fax:707-252-8452
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2012-04-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG52009207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF07966Medicare UPIN