Provider Demographics
NPI:1134105638
Name:MCKEE, VICTOR (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:MCKEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 DARROW RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-5021
Mailing Address - Country:US
Mailing Address - Phone:330-656-5911
Mailing Address - Fax:330-656-5901
Practice Address - Street 1:8401 MARKET ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-6725
Practice Address - Country:US
Practice Address - Phone:330-729-2929
Practice Address - Fax:330-656-5901
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056788207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0708523Medicaid
OH000000383091OtherANTHEM
OH001474682-0003OtherPENNSYLVANIA MEDICAID
OH000000349348OtherANTHEM
OH000000028430OtherANTHEM
OH000000381140OtherANTHEM
OH000000028430OtherANTHEM
OHMC0659801Medicare PIN
OH0659806Medicare PIN
OHMC0659805Medicare PIN
OH000000381140OtherANTHEM
OHD32499Medicare UPIN
OH080114258Medicare PIN
OH001474682-0003OtherPENNSYLVANIA MEDICAID
OHMC0659804Medicare PIN