Healthcare Provider Details

I. General information

NPI: 1639166143
Provider Name (Legal Business Name): MICHAEL T MCCOY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 SW 3RD ST
TOPEKA KS
66606-2442
US

IV. Provider business mailing address

2660 SW 3RD ST
TOPEKA KS
66606-2442
US

V. Phone/Fax

Practice location:
  • Phone: 785-270-8880
  • Fax: 785-270-8881
Mailing address:
  • Phone: 785-270-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number0418898
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number04-18898
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: