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NPI Code Detail

MEDICARE: MR. ROBERT GEORGE MCCOY DC

MEDICARE: MR. ROBERT GEORGE MCCOY DC
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
1111N00000XChiropractor1009SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14996016OTHERSDWELLMARK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679621064
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT GEORGE MCCOY DC
Provider Business Mailing Address
First Line : 5124 S WESTERN AVE
Second Line : STE 1
City : SIOUX FALLS
State : SD
Zip : 57108-5047
Country : US
Telephone Number : 605-339-3300
Fax Number : 605-339-8880
Provider Business Practice Location Address
First Line : 5124 S WESTERN AVE
Second Line : STE 1
City : SIOUX FALLS
State : SD
Zip : 57108-5047
Country : US
Telephone Number : 605-339-3300
Fax Number : 605-339-8880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 05/03/2018

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Directions to “ MR. ROBERT GEORGE MCCOY DC” Practice Location

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