Mccoy, Clark Steven

Mccoy, Clark Steven is an individual health care provider with primary practice located at 1120 E Elizabeth St Ste 2 , Fort Collins CO 80524-4044. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Mccoy, Clark Steven can be contacted via phone (970) 493-9193.

Contact Information

Primary practice address
1120 E Elizabeth St Ste 2 Fort Collins CO 80524-4044
Phone: (970) 493-9193
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X CDRH.0054001 Colorado
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD2019-0018 New Mexico
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X MD2019-0018 New Mexico

Profile Details

NPI number 1871517912
LBN Legal business name Mccoy, Clark Steven
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Dec 12th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871517912 NPPES
Other 258651 AVMED
Other 31540 AVMED
MEDICAID 250902400 AVMED
MEDICAID 19505523 AVMED

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