Provider Demographics
NPI:1811958846
Name:MCBEE, VICKIE L (PA)
Entity type:Individual
Prefix:
First Name:VICKIE
Middle Name:L
Last Name:MCBEE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:VICKIE
Other - Middle Name:L
Other - Last Name:FIXLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1401 W PAWNEE ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OK
Mailing Address - Zip Code:74020-3033
Mailing Address - Country:US
Mailing Address - Phone:918-358-2501
Mailing Address - Fax:918-358-9274
Practice Address - Street 1:1401 W PAWNEE ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OK
Practice Address - Zip Code:74020-3033
Practice Address - Country:US
Practice Address - Phone:918-358-2501
Practice Address - Fax:918-358-9274
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK616363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100193780BMedicaid
OK100193780AMedicaid
OKP00630009Medicare PIN
OK970020572Medicare PIN
OK100193780BMedicaid
OKS24487Medicare UPIN
OK243327604Medicare PIN