Provider Demographics
NPI:1447312822
Name:MCCOY, LOREN E (MD FACP)
Entity type:Individual
Prefix:DR
First Name:LOREN
Middle Name:E
Last Name:MCCOY
Suffix:
Gender:M
Credentials:MD FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2550
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661
Mailing Address - Country:US
Mailing Address - Phone:256-386-0808
Mailing Address - Fax:256-389-8904
Practice Address - Street 1:2400 EAST AVALON
Practice Address - Street 2:STE C
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661
Practice Address - Country:US
Practice Address - Phone:256-386-0808
Practice Address - Fax:256-389-8904
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19137207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000038735Medicaid
1730149071OtherGROUP NPI
G06874Medicare UPIN
AL110152290Medicare PIN
AL000038735Medicare PIN