Provider Demographics
NPI:1497891741
Name:MCKOWEN & DAY MD PC
Entity Type:Organization
Organization Name:MCKOWEN & DAY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:G
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-222-4191
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-1202
Mailing Address - Country:US
Mailing Address - Phone:334-222-4191
Mailing Address - Fax:334-222-9069
Practice Address - Street 1:125 MEDICAL PARK DR
Practice Address - Street 2:SUITE 106
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-5316
Practice Address - Country:US
Practice Address - Phone:334-222-4191
Practice Address - Fax:334-222-9069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL528902180Medicaid
ALC453OtherBLUE CROSS BLUE SHIELD AL
ALC453Medicare ID - Type Unspecified
ALC453OtherBLUE CROSS BLUE SHIELD AL