Provider Demographics
NPI:1386651503
Name:MCKEEVER, EARL JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:EARL
Middle Name:JOSEPH
Last Name:MCKEEVER
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 1:1002 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-3121
Mailing Address - Country:US
Mailing Address - Phone:641-842-2151
Mailing Address - Fax:641-842-1470
Practice Address - Street 1:1202 W HOWARD ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-3103
Practice Address - Country:US
Practice Address - Phone:641-828-7211
Practice Address - Fax:641-842-7030
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16625207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA7305250Medicaid
IA36312OtherWELLMARK BC&BS IA
IAI12097Medicare ID - Type Unspecified
IA7305250Medicaid