Provider Demographics
NPI:1467772392
Name:PRIOR, DAVID MCKEON (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MCKEON
Last Name:PRIOR
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 1:1995 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-2423
Mailing Address - Country:US
Mailing Address - Phone:330-332-7840
Mailing Address - Fax:330-332-7847
Practice Address - Street 1:1995 E STATE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-2423
Practice Address - Country:US
Practice Address - Phone:330-332-7840
Practice Address - Fax:330-332-7847
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301096380207X00000X, 390200000X
FLME153991207XS0117X
CAA135084207XS0117X
AZ57942207XS0117X
VA0101259513207XS0117X
OH35-146823207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA146777392OtherHEALTHKEEPERS PLUS
VA146777392OtherAETNA
VA146777392OtherHUMANA MEDICARE
VA146777392OtherVA PREMIER
VA146777392OtherANTHEM
VA146777392OtherUMWA
VA146777392OtherOPTIMA HEALTH PLAN
VA146777392OtherUNITED HEALTHCARE
VA146777392OtherCIGNA
VA146777392OtherTRICARE
VA146777392Medicaid
VA146777392OtherHEALTHKEEPERS
VA146777392OtherUMWA