Provider Demographics
NPI:1720187040
Name:MCGEE, JESSE E (MD)
Entity Type:Individual
Prefix:MR
First Name:JESSE
Middle Name:E
Last Name:MCGEE
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 1:4567 MILLBRANCH ROAD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116
Mailing Address - Country:US
Mailing Address - Phone:901-345-1454
Mailing Address - Fax:901-345-1456
Practice Address - Street 1:4567 MILLBRANCH ROAD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116
Practice Address - Country:US
Practice Address - Phone:901-345-1454
Practice Address - Fax:901-345-1456
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000011943207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3173758Medicaid
B03615Medicare UPIN
3173759Medicare ID - Type Unspecified
TN3173758Medicaid