Provider Demographics
NPI:1255480299
Name:MCCUE, JOHN FRANCIS (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCIS
Last Name:MCCUE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12715 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22747-1933
Mailing Address - Country:US
Mailing Address - Phone:540-675-3080
Mailing Address - Fax:540-675-3078
Practice Address - Street 1:12715 LEE HWY
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:VA
Practice Address - Zip Code:22747-1933
Practice Address - Country:US
Practice Address - Phone:540-675-3080
Practice Address - Fax:540-675-3078
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102049877207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAMAMSIOther296816
VA5624215Medicaid
VAANTHEMOther218665
VAMAMSIOther296816
VAF87141Medicare UPIN