Provider Demographics
NPI:1366440042
Name:MCKEE, OLIVER A (MD)
Entity Type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:A
Last Name:MCKEE
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 1:2325 DOUGHERTY FERRY RD
Mailing Address - Street 2:STE 201
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3356
Mailing Address - Country:US
Mailing Address - Phone:314-993-1714
Mailing Address - Fax:314-993-1718
Practice Address - Street 1:2325 DOUGHERTY FERRY RD
Practice Address - Street 2:STE 201
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3356
Practice Address - Country:US
Practice Address - Phone:314-993-1714
Practice Address - Fax:314-993-1718
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36494207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO321800001Medicare PIN
ILK09061Medicare PIN
MOA10634Medicare UPIN
ILA10634Medicare UPIN