Provider Demographics
NPI:1518052901
Name:MCCOY, TERRENCE FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:FRANCIS
Last Name:MCCOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7525 B STATE ROAD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255
Mailing Address - Country:US
Mailing Address - Phone:513-232-4400
Mailing Address - Fax:513-233-4382
Practice Address - Street 1:7525 B STATE ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255
Practice Address - Country:US
Practice Address - Phone:513-232-4400
Practice Address - Fax:513-233-4382
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35058974M207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0000000323246OtherANTHEM
OH0933557Medicaid
OH0933557Medicaid
OH0000000323246OtherANTHEM