Provider Information for 1083700751
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PETER E. MCCOY
Sex: Male
NPI: 1083700751
Last Updated: 2024-12-23
Certification Date: 2024-12-23
Certification Date: 2024-12-23
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1083700751 | ||||||||||||
| Enumeration Date | 2006-10-04 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 752991 LAS VEGAS, NV 89136-2991 United States Phone: 702-638-2744 | Fax: | ||||||||||||
| Primary Practice Address | 6900 N PECOS RD NORTH LAS VEGAS, NV 89086-4400 United States Phone: 702-638-2744 | Fax: | ||||||||||||
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