Provider Demographics
NPI:1912902321
Name:MCCOY, FRANK P (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:P
Last Name:MCCOY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 HOSPITAL SOUTH DR
Mailing Address - Street 2:STE 300
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-8116
Mailing Address - Country:US
Mailing Address - Phone:770-944-2830
Mailing Address - Fax:678-581-7170
Practice Address - Street 1:340 KENNESTONE HOSPITAL BLVD
Practice Address - Street 2:STE 200
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1121
Practice Address - Country:US
Practice Address - Phone:770-281-5100
Practice Address - Fax:678-581-7100
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA032945174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00426797BMedicaid
GA00426797CMedicaid
GA00426797GMedicaid
GA00426797FMedicaid
GA00426797BMedicaid
GA90BDBFKMedicare PIN