Provider Demographics
NPI:1700818804
Name:MCCOY, DENNIS DEWAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:DEWAYNE
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 1:8000 CENTERVIEW PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4289
Mailing Address - Country:US
Mailing Address - Phone:901-249-5905
Mailing Address - Fax:901-249-5940
Practice Address - Street 1:8000 CENTERVIEW PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4289
Practice Address - Country:US
Practice Address - Phone:901-249-5905
Practice Address - Fax:901-249-5940
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41050207L00000X, 208VP0014X
TNMD4150208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty