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General NPI Number Information
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NPI Number | 1003856659
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Entity Type | Individual
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Provider Name | BRIAN TODD MCKINLEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 10 MEMBERS WAY STE 403
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City | DOVER
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State | NH
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Zip | 03820-5933
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Country | US
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Telephone | 603-742-6664
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 412503
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City | BOSTON
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State | MA
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Zip | 02241-2503
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Country | US
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Telephone | 617-643-8315
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Fax | 941-761-0599
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 21360
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | ME 97774
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 33133
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License Number State | NH
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