Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 022823 | GA |
N | 2080P0203X | Pediatric Critical Care Doctor | 022823 | GA |
NPI | 1104980754 |
---|---|
Provider Name | Dr. Thomas W. Mckee |
First Address | Savannah, GA 31404-6220 |
Second Address | Savannah, GA 31404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 08/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000223308B | (05) | GA |
10065026 | AMERIGROUP (01) | GA |
349803 | WELLCARE (01) | GA |
37BBFTQ | OLD PTAN, TERM'D DUE TO INACTIVITY (01) | GA |
D46086 | (02) | GA |
G22823 | (05) | SC |