Provider Demographics
NPI:1821728486
Name:MCCOY, DEBORAH GAY
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:GAY
Last Name:MCCOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 CARTER CT
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-1095
Mailing Address - Country:US
Mailing Address - Phone:513-431-7040
Mailing Address - Fax:
Practice Address - Street 1:706 CARTER CT
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1095
Practice Address - Country:US
Practice Address - Phone:513-431-7040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0906904253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care