Provider Demographics
NPI:1841359486
Name:MCKEAN, THOMAS KEVIN (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:KEVIN
Last Name:MCKEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SECOND AVENUE, N.E.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5045
Mailing Address - Country:US
Mailing Address - Phone:828-324-9900
Mailing Address - Fax:828-324-8322
Practice Address - Street 1:24 SECOND AVENUE, N.E.
Practice Address - Street 2:SUITE 201
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5045
Practice Address - Country:US
Practice Address - Phone:828-324-9900
Practice Address - Fax:828-324-8322
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97-006622084P0800X
NC97006622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891042MMedicaid
2241104Medicare PIN
NCG56354Medicare UPIN
NC2241104Medicare PIN
NC891042MMedicaid