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General NPI Number Information
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NPI Number | 1225212285
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Entity Type | Individual
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Provider Name | MARC R MCKINLEY D.O.
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Gender | Male
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Dates
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Enumeration Date | 12/26/2007
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 504 N MACARTHUR AVE
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City | PANAMA CITY
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State | FL
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Zip | 32401-3636
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Country | US
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Telephone | 850-769-2158
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Fax |
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Provider Business Mailing Address
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Address Line | 120 W 22ND ST STE 300
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City | OAK BROOK
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State | IL
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Zip | 60523-4071
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Country | US
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Telephone | 630-573-5000
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Fax | 630-368-0280
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 58.002415
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 34009847
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | OS14763
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License Number State | FL
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