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General NPI Number Information
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NPI Number | 1316945819
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Entity Type | Individual
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Provider Name | BRIAN JOHN MCKINNON MD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 11110 MEDICAL CAMPUS RD STE 250
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City | HAGERSTOWN
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State | MD
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Zip | 21742-6756
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Country | US
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Telephone | 301-665-4960
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Fax |
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Provider Business Mailing Address
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Address Line | 11110 MEDICAL CAMPUS RD STE 250
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City | HAGERSTOWN
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State | MD
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Zip | 21742-6756
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Country | US
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Telephone | 301-665-4960
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | D0042364
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | S2843
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License Number State | TX
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