Provider Demographics
NPI:1720089410
Name:MCCOY, JAMES ARTHUR (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ARTHUR
Last Name:MCCOY
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 1:75 PIEDMONT AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-2544
Mailing Address - Country:US
Mailing Address - Phone:404-756-5764
Mailing Address - Fax:404-756-5252
Practice Address - Street 1:75 PIEDMONT AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-2544
Practice Address - Country:US
Practice Address - Phone:404-756-1480
Practice Address - Fax:404-756-1489
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017852208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00083641BDMedicaid
GA26LCBGTMedicare ID - Type Unspecified
D46064Medicare UPIN