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NPI Code Detail

MEDICARE: DONALD RANDOLPH MCKINLEY MD

MEDICARE: DONALD RANDOLPH MCKINLEY MD
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
1207V00000XObstetrics & Gynecology Physician0101034676VA
2207V00000XObstetrics & Gynecology Physician2013-01534NC

General Provider Information

NPI Number : 1689664336
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD RANDOLPH MCKINLEY MD
Provider Business Mailing Address
First Line : 5221 PARAMOUNT PKWY STE 220
Second Line :
City : MORRISVILLE
State : NC
Zip : 27560-5490
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4901 DAWN DR STE 3200
Second Line :
City : LUMBERTON
State : NC
Zip : 28360-8288
Country : US
Telephone Number : 910-735-8040
Fax Number : 910-608-3079
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2005
Last Update Date : 02/12/2025

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