MEDICARE: JOHN MCKINLEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	F6934	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093798811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN MCKINLEY MD

Provider Business Mailing Address
First Line	:	PO BOX 840026
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-0026
Country	:	US
Telephone Number	:	806-212-6965
Fax Number	:	806-212-6278

Provider Business Practice Location Address
First Line	:	6 MEDICAL DR
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-4136
Country	:	US
Telephone Number	:	806-212-6604
Fax Number	:	806-212-0355

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2005
Last Update Date	:	10/04/2017

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Directions to “ JOHN MCKINLEY MD” Practice Location

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