Provider Demographics
NPI:1093521767
Name:MCGEE, DORIS
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:MCGEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 CROSS PARK DR APT 153
Mailing Address - Street 2:
Mailing Address - City:PEARL
Mailing Address - State:MS
Mailing Address - Zip Code:39208-8914
Mailing Address - Country:US
Mailing Address - Phone:601-988-7058
Mailing Address - Fax:
Practice Address - Street 1:330 CROSS PARK DR APT 153
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-8914
Practice Address - Country:US
Practice Address - Phone:601-988-7058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS800050741172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver