Provider Demographics
NPI:1306888417
Name:MCKEE, THEODORE B (DPM)
Entity type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:B
Last Name:MCKEE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-2147
Mailing Address - Country:US
Mailing Address - Phone:540-887-9815
Mailing Address - Fax:
Practice Address - Street 1:111 FAIRWAY LN
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-3563
Practice Address - Country:US
Practice Address - Phone:540-885-8891
Practice Address - Fax:540-885-0016
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300877213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1588847982OtherNPI GROUP LEXINGTON
VA1306888417OtherNPI
VA1336330620OtherSOUTHERN HEALTH
VA305246OtherANTHEM BCBS
VAC10346OtherMEDICARE GROUP
VA1336330620OtherVIRGINIA PREMIER
VA1336330620OtherNPI GROUP STAUNTON
VADG6187OtherRAILROAD MEDICARE GROUP
VAP00444410OtherRAILROAD MEDICARE PIN
VA1336330620OtherCIGNA MEDICARE SERVCIES
VA305227OtherANTHEM BCBS LEXINGTON
VA1336330620Medicaid
VA1336330620OtherSOUTHERN HEALTH
VA00X561B02Medicare PIN
VAP00444410OtherRAILROAD MEDICARE PIN
VADG6187OtherRAILROAD MEDICARE GROUP
VA1306888417OtherNPI
VA1588847982OtherNPI GROUP LEXINGTON