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Individual

DR. JOHN D MCKIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
224 W D. L. INGRAM AVENUE, BLDG. 1408, CANON AFB, NM 88130
(575) 784-2778
Mailing address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
A-2419-20
NM
207P00000X
Emergency Medicine Physician
Primary
A-2419-20
NM
208D00000X
General Practice Physician
2016017267
MO

Other

Enumeration date
04/02/2016
Last updated
04/04/2024
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