1518079227 NPI number — WILLIAM P MCKAY MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518079227 NPI number — WILLIAM P MCKAY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCKAY
Provider First Name:
WILLIAM
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518079227
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 101199
Provider Second Line Business Mailing Address:
WILLIAM P MCKAY MD
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30392-1199
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-429-1411
Provider Business Mailing Address Fax Number:
770-429-1951

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4750 BATTLEFIELD PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RINGGOLD
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30736-5164
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-841-8050
Provider Business Practice Location Address Fax Number:
706-841-0013
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X , with the licence number:  026001 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000385217C , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 801621 . This is a "BCBS" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 00385217A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 300036633 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 300036633 . This is a "UNTIED HEALTHCARE" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".




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