Healthcare Provider Details

I. General information

NPI: 1649228644
Provider Name (Legal Business Name): CONTANCE JEAN MCKEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3073 PANTHERSVILLE RD
DECATUR GA
30034-3828
US

IV. Provider business mailing address

P. O. BOX 370407
DECATUR GA
30034-3828
US

V. Phone/Fax

Practice location:
  • Phone: 404-243-2100
  • Fax: 404-243-2159
Mailing address:
  • Phone: 404-243-2100
  • Fax: 404-243-2159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number035689
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: