Provider Demographics
NPI:1811435837
Name:MCCAIN, EMILY (CPT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 N YALE ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-3660
Mailing Address - Country:US
Mailing Address - Phone:662-588-6231
Mailing Address - Fax:
Practice Address - Street 1:1010 N YALE ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-3660
Practice Address - Country:US
Practice Address - Phone:662-588-6231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS037865-PT15246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy