Provider Demographics
NPI:1578570222
Name:MCCOY, MICHAEL LEROY (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEROY
Last Name:MCCOY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1101 SOUTH 70TH STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4293
Mailing Address - Country:US
Mailing Address - Phone:402-488-1400
Mailing Address - Fax:402-488-3879
Practice Address - Street 1:1101 SOUTH 70TH STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4293
Practice Address - Country:US
Practice Address - Phone:402-488-1400
Practice Address - Fax:402-488-3879
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2010-02-01
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Provider Licenses
StateLicense IDTaxonomies
NE12695207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE080074451OtherRAILROAD MEDICARE
NE080074451OtherRAILROAD MEDICARE
NEB67722Medicare UPIN