Provider Demographics
NPI:1730179268
Name:MCCOY, JULIA M (MD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:M
Last Name:MCCOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 16563
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72231-6563
Mailing Address - Country:US
Mailing Address - Phone:501-945-4710
Mailing Address - Fax:501-955-9027
Practice Address - Street 1:3500 SPRINGHILL DR
Practice Address - Street 2:
Practice Address - City:N LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2948
Practice Address - Country:US
Practice Address - Phone:501-945-4710
Practice Address - Fax:501-955-9027
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC77252084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARF81963Medicare UPIN
AR5J435Medicare ID - Type Unspecified