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NPI Code Detail

MEDICARE: DR. WADE T MCCOY MD

MEDICARE: DR. WADE T MCCOY MD
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
1207Q00000XFamily Medicine Physician20023OK

General Provider Information

NPI Number : 1184696528
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WADE T MCCOY MD
Provider Business Mailing Address
First Line : 7530 NW 23RD ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73003
Country : US
Telephone Number : 405-787-7747
Fax Number : 405-789-6734
Provider Business Practice Location Address
First Line : 7530 NW 23RD ST
Second Line :
City : BETHANY
State : OK
Zip : 73008-4921
Country : US
Telephone Number : 405-787-7747
Fax Number : 405-789-6734
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 08/03/2015

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Directions to “ DR. WADE T MCCOY MD” Practice Location

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