Healthcare Provider Details

I. General information

NPI: 1760542823
Provider Name (Legal Business Name): JOHN K. MCGEE J.R., M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 07/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 HOSPITAL RD SUITE B
ATWATER CA
95301-5173
US

IV. Provider business mailing address

3144 G STREET SUITE 125-317
MERCED CA
95340-1384
US

V. Phone/Fax

Practice location:
  • Phone: 209-724-4132
  • Fax:
Mailing address:
  • Phone: 209-726-3799
  • Fax: 661-869-2003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberC43296
License Number StateCA

VIII. Authorized Official

Name: JOHN K MCGEE JR.
Title or Position: OWNER
Credential: M.D.
Phone: 209-724-4132