MEDICARE: THOMAS A MCKEE DDS PC

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	122300000X	Dentist	0401007960	VA

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	:	1801309596
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS A MCKEE DDS PC

Provider Business Mailing Address
First Line	:	5261 CHALLEDON DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6315
Country	:	US
Telephone Number	:	757-499-2444
Fax Number	:	757-497-7518

Provider Business Practice Location Address
First Line	:	5261 CHALLEDON DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6315
Country	:	US
Telephone Number	:	757-499-2444
Fax Number	:	757-497-7518

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. THOMAS ATWOOD MCKEE
Credential	:	DDS
Telephone Number	:	757-499-2444

Provider Enumeration Date	:	11/16/2017
Last Update Date	:	11/16/2017

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