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General NPI Number Information
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NPI Number | 1427580943
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Entity Type | Individual
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Provider Name | GRANT MCKINLEY DO
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Gender | Male
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 3000 MACK RD STE 100
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City | FAIRFIELD
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State | OH
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Zip | 45014-5335
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Country | US
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Telephone | 513-751-4222
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Fax | 513-874-3023
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Provider Business Mailing Address
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Address Line | 3000 MACK RD STE 100
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City | FAIRFIELD
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State | OH
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Zip | 45014-5335
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Country | US
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Telephone | 513-751-4222
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Fax | 513-874-3023
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 94-10131
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 05-47607
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 34.018088
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License Number State | OH
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