Healthcare Provider Details

I. General information

NPI: 1720440076
Provider Name (Legal Business Name): BRYCE CAMERON MCKEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2016
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 S LANDMARK AVE
BLOOMINGTON IN
47403
US

IV. Provider business mailing address

350 S LANDMARK AVE
BLOOMINGTON IN
47403-5001
US

V. Phone/Fax

Practice location:
  • Phone: 812-332-9874
  • Fax: 812-335-7604
Mailing address:
  • Phone: 812-332-9874
  • Fax: 812-335-7604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01081882A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: