Provider Demographics
NPI:1790779189
Name:MCKOY, ROBERT CURTIS (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CURTIS
Last Name:MCKOY
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:PO BOX 606
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37401-0606
Mailing Address - Country:US
Mailing Address - Phone:423-602-5536
Mailing Address - Fax:
Practice Address - Street 1:2339 MCCALLIE AVE STE 403
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3209
Practice Address - Country:US
Practice Address - Phone:423-602-5536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18943207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3856544Medicaid
TN3856544Medicaid
TN3856544Medicare ID - Type Unspecified