Provider Demographics
NPI:1346433935
Name:MCKEEVER, JAIME
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:MCKEEVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11590 N MERIDIAN ST SUITE 170
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:317-848-3040
Mailing Address - Fax:317-848-5380
Practice Address - Street 1:11590 N MERIDIAN ST SUITE 170
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032
Practice Address - Country:US
Practice Address - Phone:317-848-3040
Practice Address - Fax:317-848-5380
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11012046A208000000X
IN01064405A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics