Provider Demographics
NPI:1477593382
Name:MCKEE, KIETH DALE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KIETH
Middle Name:DALE
Last Name:MCKEE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3501 NW 63RD STREET
Mailing Address - Street 2:SUITE 405
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116
Mailing Address - Country:US
Mailing Address - Phone:405-841-3003
Mailing Address - Fax:405-841-3883
Practice Address - Street 1:3501 NW 63RD STREET
Practice Address - Street 2:SUITE 405
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116
Practice Address - Country:US
Practice Address - Phone:405-841-3003
Practice Address - Fax:405-841-3883
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK399103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R25163Medicare UPIN