IndividualActive
Justin Mccoy, DO
NPI 1265792238 · Sports Medicine (Family Medicine) Physician · Boise, ID
Provider details
- NPI number
- 1265792238
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- O-0857 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
777 N Raymond St
Boise, ID 83704-9251
Phone: (208) 514-2500
Fax: (208) 375-2217
Approximate (ZIP-level) locationGet directions
Mailing address
777 N Raymond St
Boise, ID 83704-9251
Registry dates
- Enumerated
- 2012-05-23
- Last updated
- 2023-05-25
- Certified
- 2023-05-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.