MEDICARE: DR. CYNTHIA JOAN MCCOY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	18972	OK

General Provider Information

NPI Number	:	1831180322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA JOAN MCCOY M.D.

Provider Business Mailing Address
First Line	:	1615 S 69TH EAST AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74112-7438
Country	:	US
Telephone Number	:	918-836-2962
Fax Number	:

Provider Business Practice Location Address
First Line	:	1615 S 69TH EAST AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74112-7438
Country	:	US
Telephone Number	:	918-836-2962
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	06/03/2012

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