Provider Demographics
NPI:1336234178
Name:MCGEE, TOMMY NEAL (DMD)
Entity type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:NEAL
Last Name:MCGEE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-2511
Mailing Address - Country:US
Mailing Address - Phone:256-574-3609
Mailing Address - Fax:256-259-0529
Practice Address - Street 1:1005 S BROAD ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-2511
Practice Address - Country:US
Practice Address - Phone:256-574-3609
Practice Address - Fax:256-259-0529
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL38721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL94512OtherBC/BS PROVIDER NUMBER