Provider Demographics
NPI:1871862763
Name:HENRY E. MCKAY, III, DDS, PC
Entity Type:Organization
Organization Name:HENRY E. MCKAY, III, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL MAXILLOFACIAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:MCKAY
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:205-933-1331
Mailing Address - Street 1:1112 19TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4814
Mailing Address - Country:US
Mailing Address - Phone:205-933-1331
Mailing Address - Fax:205-933-1353
Practice Address - Street 1:1112 19TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-4814
Practice Address - Country:US
Practice Address - Phone:205-933-1331
Practice Address - Fax:205-933-1353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL46491223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL92636Medicare UPIN