Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 40602 | TN |
NPI | 1023087764 |
---|---|
Provider Name | William Anthony Mcgee |
First Address | West Plains, MO 65775-1100 |
Second Address | West Plains, MO 65775 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 10/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10990640 | CAQH (01) | |
4117593 | BLUECROSS BLUESHIELD TN (01) | TN |
F43011 | (02) |