Basic Information
Provider Information
NPI: 1134187818
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCKEE
FirstName: HEATHER
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 400
Address2:  
City: JACKSON
State: TN
PostalCode: 383020400
CountryCode: US
TelephoneNumber: 7314255752
FaxNumber: 7314225743
Practice Location
Address1: 2863 HIGHWAY 45 BYP
Address2:  
City: JACKSON
State: TN
PostalCode: 383053618
CountryCode: US
TelephoneNumber: 7314220213
FaxNumber: 7316608336
Other Information
ProviderEnumerationDate: 05/03/2006
LastUpdateDate: 04/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/05/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X30870TNY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home