Provider Demographics
NPI:1104810704
Name:MCKEE, WILLIAM NEIL (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:NEIL
Last Name:MCKEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-2025
Mailing Address - Country:US
Mailing Address - Phone:731-287-4500
Mailing Address - Fax:731-287-4804
Practice Address - Street 1:1700 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-2028
Practice Address - Country:US
Practice Address - Phone:731-287-4500
Practice Address - Fax:731-287-4804
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20151207RP1001X
TNMD020151207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8142OtherTLC MEMPHIS MANAGED CARE
4662360OtherAETNA
118135OtherBETTER HEALTH PLAN
110085870OtherPALMETTO GBA
TN3146535OtherBL CROSS
0440786OtherUNITED HEALTHCARE
2010140OtherCIGNA
TN3074060Medicaid
2010140OtherCIGNA
8142OtherTLC MEMPHIS MANAGED CARE