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NPI 1144176199

NPI 1144176199 : MICHAEL FRED MCKINLEY : SUNBURY, OH

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General NPI Number Information
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    NPI Number           |    1144176199
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    Entity Type          |    Individual 
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    Provider Name        |    MICHAEL FRED MCKINLEY
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/10/2026
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    Last Update Date     |    03/10/2026
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Provider Practice Location Address
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    Address Line         |    892 ADMIRAL DR 
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    City                 |    SUNBURY
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    State                |    OH
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    Zip                  |    43074-7557
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    Country              |    US
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    Telephone            |    419-688-1532
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9 MILL RD 
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    City                 |    BELLVILLE
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    State                |    OH
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    Zip                  |    44813-1270
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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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        |    385HR2060X
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    Taxonomy Name        |    Child Intellectual and/or Developmental Disabilities Respite Care
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    License Number       |    
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    License Number State |    
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