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NPI Code Detail

MEDICARE: KATHLEEN MARIE MCCOY RDMS, BS

MEDICARE:   KATHLEEN MARIE MCCOY  RDMS, BS
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
1246XS1301XSonography Specialist/Technologist Cardiovascular12343IN

General Provider Information

NPI Number : 1134209943
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN MARIE MCCOY RDMS, BS
Provider Business Mailing Address
First Line : 309 GROVE ST
Second Line :
City : ALBION
State : IN
Zip : 46701-1089
Country : US
Telephone Number : 260-636-3316
Fax Number :
Provider Business Practice Location Address
First Line : 1819 CAREW ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4705
Country : US
Telephone Number : 260-481-4785
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2006
Last Update Date : 07/08/2007

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Directions to “ KATHLEEN MARIE MCCOY RDMS, BS” Practice Location

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