Provider Demographics
NPI:1982877528
Name:MCKEE, SUSAN WILLIAMS (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:WILLIAMS
Last Name:MCKEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1169 EASTERN PKWY
Mailing Address - Street 2:SUITE G71
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-1417
Mailing Address - Country:US
Mailing Address - Phone:502-456-2008
Mailing Address - Fax:502-456-4440
Practice Address - Street 1:4000 KRESGE WAY STE P1503
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4605
Practice Address - Country:US
Practice Address - Phone:502-456-2008
Practice Address - Fax:502-456-4440
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45033207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000818207OtherANTHEM
KY50050822OtherPASSPORT
KY7100244470Medicaid
IN201167790AMedicaid
KY50050822OtherPASSPORT