Individual
JACQUELYN R MCKEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
81 RESERVOIR DR, ATHOL, MA 01331-4901
(978) 248-5135
Mailing address
26 QUEEN ST, MEDICAL, WORCESTER, MA 01610-2473
(508) 860-7700
(508) 860-7990
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
206096
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006767
NHP-GROUP
MA
01
—
0035749
NHP
MA
01
—
042485308
NETWORK HEALTH-GROUP
MA
05
—
1300709
—
MA
01
—
2437886
CIGNA
MA
01
—
49201
FALLON SELECT
MA
01
—
81738
CMSP
MA
01
—
97679702
NETWORK HEALTH
MA
01
—
AA25557
HARVARD PILGRIM
MA
01
—
J23197
BCBS
MA
01
—
Y10141
BCBS-GROUP
MA
Enumeration date
08/11/2006
Last updated
01/30/2020
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