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General NPI Number Information
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NPI Number | 1982418190
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Entity Type | Organization
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Legal Business Name | MICHAEL T. MCCORMICK & ASSOCIATES PA
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 17835 MURDOCK CIR
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-4000
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Country | US
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Telephone | 941-624-6300
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Fax | 941-624-6157
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Provider Business Mailing Address
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Address Line | PO BOX 825159
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City | PHILADELPHIA
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State | PA
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Zip | 19182-5159
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER AND CEO
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Name | ROY CLINT LAIRD
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Credential |
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Telephone | 941-493-8666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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