Provider Demographics
NPI:1750733580
Name:EUGENE H MCCOSKEY, D.O., P.A.
Entity type:Organization
Organization Name:EUGENE H MCCOSKEY, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCCOSKEY
Authorized Official - Suffix:II
Authorized Official - Credentials:DO
Authorized Official - Phone:904-923-0582
Mailing Address - Street 1:PO BOX 380009
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-0509
Mailing Address - Country:US
Mailing Address - Phone:904-388-3357
Mailing Address - Fax:904-384-5746
Practice Address - Street 1:1555 KINGSLEY AVE STE 404
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-9207
Practice Address - Country:US
Practice Address - Phone:904-441-1111
Practice Address - Fax:904-384-5746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8208207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS8208OtherMEDICAL LICENSE
FLG13337Medicare UPIN