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NPI Code Detail

MEDICARE: DR. A. CLINTON MACKINNEY MD, MS

MEDICARE:  DR. A. CLINTON MACKINNEY  MD, MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician27914MN

General Provider Information

NPI Number : 1295718336
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. A. CLINTON MACKINNEY MD, MS
Provider Business Mailing Address
First Line : 33921 N 91ST AVE
Second Line :
City : SAINT JOSEPH
State : MN
Zip : 56374
Country : US
Telephone Number : 320-363-8150
Fax Number :
Provider Business Practice Location Address
First Line : 815 2ND ST SE
Second Line :
City : LITTLE FALLS
State : MN
Zip : 56345-3505
Country : US
Telephone Number : 320-632-5441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 07/08/2007

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Directions to “ DR. A. CLINTON MACKINNEY MD, MS” Practice Location

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