Provider Demographics
NPI:1790723096
Name:MCCORD, JOSEPH W JR (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:W
Last Name:MCCORD
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:4167 HOSPITAL DR NE
Mailing Address - Street 2:GEORGIA OPHTHALMOLOGISTS, LLC
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2565
Mailing Address - Country:US
Mailing Address - Phone:770-786-1234
Mailing Address - Fax:
Practice Address - Street 1:4167 HOSPITAL DR NE
Practice Address - Street 2:GEORGIA OPHTHALMOLOGISTS, LLC
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2565
Practice Address - Country:US
Practice Address - Phone:770-786-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101007924207L00000X
KY02739207L00000X
ALDO-87207L00000X
MS14170207L00000X
TND.O.-632207L00000X
ARE0202207L00000X
GA039174207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK025581OtherMEDICARE
IN300007918Medicaid
IN300007918Medicaid