MEDICARE: DR. GARY WAYNE MCKEEL D.C.

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	111NX0100X	Occupational Health Chiropractor	1107	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184602799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY WAYNE MCKEEL D.C.

Provider Business Mailing Address
First Line	:	2007 W VANDALIA RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-7617
Country	:	US
Telephone Number	:	336-855-6316
Fax Number	:	336-854-1843

Provider Business Practice Location Address
First Line	:	2007 W VANDALIA RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-7617
Country	:	US
Telephone Number	:	336-855-6316
Fax Number	:	336-854-1843

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	07/08/2007

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