Provider Demographics
NPI:1518387869
Name:MCCORD, DORIS (MPA)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:MCCORD
Suffix:
Gender:F
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4940 PALM VIEW DR N
Mailing Address - Street 2:
Mailing Address - City:MULBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:33860-3245
Mailing Address - Country:US
Mailing Address - Phone:863-440-6575
Mailing Address - Fax:
Practice Address - Street 1:4940 PALM VIEW DR N
Practice Address - Street 2:
Practice Address - City:MULBERRY
Practice Address - State:FL
Practice Address - Zip Code:33860-3245
Practice Address - Country:US
Practice Address - Phone:863-440-6575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor