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Individual

DR. JAMES KEITH MCKECHNIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
103 PROFESSIONAL PLZ, MATTOON, IL 61938-9252
(217) 348-1030
(217) 348-1090
Mailing address
103 PROFESSIONAL PLZ, MATTOON, IL 61938-9252
(217) 348-1030
(217) 348-1090

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036058473
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002811
HEALTH ALLIANCE
IL
05
036058473
IL
01
133038
HEALTHLINK PROVDER ID
IL
01
1515701
BLUE SHIELD ID
IL
01
236090
MEDICARE PTAN
IL
01
791203439
RAILROAD MEDICARE
IL
Enumeration date
12/04/2006
Last updated
12/08/2009
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