Provider Demographics
NPI:1275569006
Name:MCGEE, TAMMY DENISE (MD)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:DENISE
Last Name:MCGEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 INEZ OWENS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-3265
Mailing Address - Country:US
Mailing Address - Phone:601-372-3665
Mailing Address - Fax:601-372-0747
Practice Address - Street 1:1860 CHADWICK DR
Practice Address - Street 2:SUITE 205
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39204-3463
Practice Address - Country:US
Practice Address - Phone:601-376-2857
Practice Address - Fax:601-376-2847
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS15981208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1429601Medicaid
MS00122067Medicaid
MS512I370053Medicare PIN