Provider Demographics
NPI:1144307398
Name:MCKAY, THOMAS P JR (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:P
Last Name:MCKAY
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 LAUREL OAK LN
Mailing Address - Street 2:
Mailing Address - City:PINEBLUFF
Mailing Address - State:NC
Mailing Address - Zip Code:28373-8020
Mailing Address - Country:US
Mailing Address - Phone:910-281-5284
Mailing Address - Fax:
Practice Address - Street 1:780 NW BROAD ST.
Practice Address - Street 2:SUITE 400
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387
Practice Address - Country:US
Practice Address - Phone:910-693-3700
Practice Address - Fax:910-693-3709
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2798111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCU79994Medicare UPIN