Provider Demographics
NPI:1265470462
Name:MCGEHEE, JOHN LUCIUS (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:LUCIUS
Last Name:MCGEHEE
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 1:395 GRANDVIEW ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-7607
Mailing Address - Country:US
Mailing Address - Phone:901-844-1434
Mailing Address - Fax:901-844-1439
Practice Address - Street 1:1669 KIRBY PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-4373
Practice Address - Country:US
Practice Address - Phone:901-755-8891
Practice Address - Fax:901-755-8820
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14874207R00000X, 207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3002931Medicaid
TN3002933Medicaid
TN14874OtherTN MEDICAL LICENSE
TN14874OtherTN MEDICAL LICENSE
TN14874OtherTN MEDICAL LICENSE
TN14874OtherTN MEDICAL LICENSE
TN3002933Medicare PIN
BM0122844OtherDEA REGISTRATION NUMBER