MEDICARE: DR. DONALD MARTIN MCCOY PH.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	103TH0100X	Health Service Psychologist	2172	TN
2	103TC0700X	Clinical Psychologist	2172	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568545416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD MARTIN MCCOY PH.D.

Provider Business Mailing Address
First Line	:	3019 DUNMIRE DR
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37129-2945
Country	:	US
Telephone Number	:	615-907-1833
Fax Number	:	615-907-7365

Provider Business Practice Location Address
First Line	:	1120 GLENDALE LN
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37204-4113
Country	:	US
Telephone Number	:	615-907-1833
Fax Number	:	615-907-7365

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	05/23/2019

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