Provider Demographics
NPI:1407075229
Name:MCGEE, ROGER LYNN JR (MD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:LYNN
Last Name:MCGEE
Suffix:JR
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:PO BOX 1000
Mailing Address - Street 2:DEPT # 74
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-516-6300
Mailing Address - Fax:
Practice Address - Street 1:7705 POPLAR AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3930
Practice Address - Country:US
Practice Address - Phone:901-516-6300
Practice Address - Fax:901-516-6350
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44014208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1508052Medicaid
TNP01091996OtherRAILROAD MEDICARE
TN4324230OtherBCBS
TN1508052Medicaid