MEDICARE: DR. PAUL JAY MCKEE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	G17741	CA

General Provider Information

NPI Number	:	1013971548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL JAY MCKEE M.D.

Provider Business Mailing Address
First Line	:	780 RANCH ROAD 2721
Second Line	:
City	:	JOHNSON CITY
State	:	TX
Zip	:	78636-4589
Country	:	US
Telephone Number	:	830-868-2587
Fax Number	:

Provider Business Practice Location Address
First Line	:	780 RANCH ROAD 2721
Second Line	:
City	:	JOHNSON CITY
State	:	TX
Zip	:	78636-4589
Country	:	US
Telephone Number	:	830-868-2587
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	07/08/2007

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