Provider Demographics
NPI:1760542823
Name:JOHN K. MCGEE J.R., M.D., INC
Entity Type:Organization
Organization Name:JOHN K. MCGEE J.R., M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:209-724-4132
Mailing Address - Street 1:3144 G STREET
Mailing Address - Street 2:SUITE 125-317
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-1384
Mailing Address - Country:US
Mailing Address - Phone:209-726-3799
Mailing Address - Fax:661-869-2003
Practice Address - Street 1:3605 HOSPITAL RD
Practice Address - Street 2:SUITE B
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-5173
Practice Address - Country:US
Practice Address - Phone:209-724-4132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC43296207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ25050ZMedicaid
CAMEDICARE RAILROADOtherP00031548
CAZZZ25050ZMedicaid
CAMEDICARE RAILROADOtherP00031548