Basic Information
Provider Information
NPI: 1831281286
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGEE
FirstName: KELLY
MiddleName: BEN
NamePrefix: DR.
NameSuffix:  
Credential: PHARM D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1853
Address2:  
City: BETHEL
State: AK
PostalCode: 995591853
CountryCode: US
TelephoneNumber: 9075435710
FaxNumber:  
Practice Location
Address1: 700 CHIEF EDDIE HOFFMAN HIGHWAY
Address2:  
City: BETHEL
State: AK
PostalCode: 99559
CountryCode: US
TelephoneNumber: 9075436382
FaxNumber: 9075436306
Other Information
ProviderEnumerationDate: 09/29/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X1589AKY Pharmacy Service ProvidersPharmacist 
183500000XP5921IDN Pharmacy Service ProvidersPharmacist 

No ID Information.


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