Provider Demographics
NPI:1124001953
Name:MCGHEE, MICHAEL A (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:MCGHEE
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 1:10201 KANIS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6203
Mailing Address - Country:US
Mailing Address - Phone:501-227-5050
Mailing Address - Fax:501-227-5151
Practice Address - Street 1:2305 SPRINGHILL RD
Practice Address - Street 2:SUITE 8
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72019-7552
Practice Address - Country:US
Practice Address - Phone:501-943-3214
Practice Address - Fax:501-943-3219
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC8454207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR040013831OtherRAILROAD MEDICARE
AR134132001Medicaid
AR040013831OtherRAILROAD MEDICARE
ARG68543Medicare UPIN