Provider Demographics
NPI:1184602799
Name:MCKEEL, GARY WAYNE (DC)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:WAYNE
Last Name:MCKEEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 W VANDALIA RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-7617
Mailing Address - Country:US
Mailing Address - Phone:336-855-6316
Mailing Address - Fax:336-854-1843
Practice Address - Street 1:2007 W VANDALIA RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-7617
Practice Address - Country:US
Practice Address - Phone:336-855-6316
Practice Address - Fax:336-854-1843
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1107111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911332Medicaid
NC244290Medicare ID - Type Unspecified
NC8911332Medicaid