Healthcare Provider Details

I. General information

NPI: 1689640039
Provider Name (Legal Business Name): RONALD SCOTT MCKECHNIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 GLENN MITCHELL DR STE 400
VIRGINIA BEACH VA
23456-0179
US

IV. Provider business mailing address

2075 GLENN MITCHELL DR STE 400
VIRGINIA BEACH VA
23456-0179
US

V. Phone/Fax

Practice location:
  • Phone: 757-252-9365
  • Fax: 757-962-7217
Mailing address:
  • Phone: 757-252-9365
  • Fax: 757-962-7217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101236030
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number0101236030
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: