Provider Demographics
NPI:1821171455
Name:MCKEY, NOEL KIRK (DC)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:KIRK
Last Name:MCKEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:KIRK
Other - Middle Name:
Other - Last Name:MCKEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC PC
Mailing Address - Street 1:469 BREEZE ST
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2648
Mailing Address - Country:US
Mailing Address - Phone:970-824-4444
Mailing Address - Fax:970-824-4448
Practice Address - Street 1:469 BREEZE ST
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2648
Practice Address - Country:US
Practice Address - Phone:970-824-4444
Practice Address - Fax:970-824-4448
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1468111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC507188Medicare PIN
COU96654Medicare UPIN