Provider Demographics
NPI:1215036272
Name:MCKAY, RICHARD C (DC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:C
Last Name:MCKAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 OMEGA DR
Mailing Address - Street 2:SUITE F54
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2062
Mailing Address - Country:US
Mailing Address - Phone:302-368-1300
Mailing Address - Fax:302-368-1695
Practice Address - Street 1:54 OMEGA DR
Practice Address - Street 2:SUITE F54
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2062
Practice Address - Country:US
Practice Address - Phone:302-368-1300
Practice Address - Fax:302-368-1695
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000209111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE438143Medicare ID - Type Unspecified
DEU23642Medicare UPIN