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NPI 1205332434

NPI 1205332434 : JOSEPH LANDON MCKINLEY DO : PARRIS ISLAND, SC

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General NPI Number Information
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    NPI Number           |    1205332434
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    Entity Type          |    Individual 
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    Provider Name        |    JOSEPH LANDON MCKINLEY DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/05/2018
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    Last Update Date     |    11/20/2023
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Provider Practice Location Address
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    Address Line         |    670 BOULEVARD DE FRANCE 
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    City                 |    PARRIS ISLAND
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    State                |    SC
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    Zip                  |    29905-0000
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    Country              |    US
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    Telephone            |    843-228-5600
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    670 BOULEVARD DE FRANCE 
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    City                 |    PARRIS ISLAND
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    State                |    SC
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    Zip                  |    29905
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    Country              |    US
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    Telephone            |    843-228-5600
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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        |    171000000X
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    Taxonomy Name        |    Military Health Care Provider
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    License Number       |    2060
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    License Number State |    NE
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    208D00000X
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    Taxonomy Name        |    General Practice Physician
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    License Number       |    2060
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    License Number State |    NE
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