Provider Demographics
NPI:1811524309
Name:MCGEE, STEPHANIE PAIGE (MD)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:PAIGE
Last Name:MCGEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:PAIGE
Other - Last Name:MILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:12955 SHELBYVILLE RD STE 2
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-1538
Practice Address - Country:US
Practice Address - Phone:502-245-4301
Practice Address - Fax:502-394-3632
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY58095207Q00000X
IL125076132207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program