Provider Demographics
NPI:1649595828
Name:THOMAS K. MCKEAN, M. D., PLLC
Entity Type:Organization
Organization Name:THOMAS K. MCKEAN, M. D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCKEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-324-9900
Mailing Address - Street 1:24 2ND AVE NE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5045
Mailing Address - Country:US
Mailing Address - Phone:828-324-9900
Mailing Address - Fax:828-324-8322
Practice Address - Street 1:24 2ND AVE NE
Practice Address - Street 2:SUITE 201
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5045
Practice Address - Country:US
Practice Address - Phone:828-324-9900
Practice Address - Fax:828-324-8322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97006622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891042MMedicaid
NC891042MMedicaid