Provider Demographics
NPI:1841298338
Name:MCGEHEE, MARY (OD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:MCGEHEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 E OASIS CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-1006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3940 E UNIVERSITY DR
Practice Address - Street 2:SUITE 5
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-6945
Practice Address - Country:US
Practice Address - Phone:480-832-0030
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ799152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ66765Medicare ID - Type Unspecified
AZU28313Medicare UPIN