Provider Demographics
NPI:1487693180
Name:MCKEE, WILLIS P (MD)
Entity type:Individual
Prefix:
First Name:WILLIS
Middle Name:P
Last Name:MCKEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PHYSICIANS PARK
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-4107
Mailing Address - Country:US
Mailing Address - Phone:502-223-7629
Mailing Address - Fax:502-223-9829
Practice Address - Street 1:1 PHYSICIANS PARK
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-4107
Practice Address - Country:US
Practice Address - Phone:502-223-7629
Practice Address - Fax:502-223-9829
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY13673208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY61-0727156OtherCHA-HEALTH
KY610727156EOtherHUMANA PIN
KY37-00021OtherUNITED HEALTHCARE
KY64136732Medicaid
KYC78543OtherBLUEGRASS FAMILY HEALTH
KY000000062412OtherANTHEM PIN
KY37-00021OtherUNITED HEALTHCARE
KY64136732Medicaid