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NPI Code Detail

MEDICARE: TYLER DANIEL MCKEE DPM

MEDICARE: TYLER DANIEL MCKEE DPM
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
1213E00000XPodiatrist07001333AIN
2213ES0103XFoot & Ankle Surgery Podiatrist07001333AIN
3213ES0103XFoot & Ankle Surgery Podiatrist306AR

General Provider Information

NPI Number : 1902338320
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER DANIEL MCKEE DPM
Provider Business Mailing Address
First Line : PO BOX 776084
Second Line :
City : CHICAGO
State : IL
Zip : 60677-6084
Country : US
Telephone Number : 314-543-6979
Fax Number : 314-364-6321
Provider Business Practice Location Address
First Line : 3501 WE KNIGHT DR
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-6254
Country : US
Telephone Number : 479-709-6700
Fax Number : 479-709-6710
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2017
Last Update Date : 03/06/2024

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