Provider Demographics
NPI:1265742225
Name:JOSEPH E MCKEOWN MD, PC
Entity type:Organization
Organization Name:JOSEPH E MCKEOWN MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCKEOWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-288-0101
Mailing Address - Street 1:420 N RIDGE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-7404
Mailing Address - Country:US
Mailing Address - Phone:804-288-0101
Mailing Address - Fax:804-288-0850
Practice Address - Street 1:420 N RIDGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-7404
Practice Address - Country:US
Practice Address - Phone:804-288-0101
Practice Address - Fax:804-288-0850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042576208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty