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NPI Code Detail

MEDICARE: PHILLIP MCKINZIE

MEDICARE: PHILLIP MCKINZIE
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
1106S00000XBehavior TechnicianRBT-25-497714OK

General Provider Information

NPI Number : 1689531436
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP MCKINZIE
Provider Business Mailing Address
First Line : 1023 W 3RD ST
Second Line :
City : ELK CITY
State : OK
Zip : 73644-5200
Country : US
Telephone Number : 405-857-8280
Fax Number :
Provider Business Practice Location Address
First Line : 1023 W 3RD ST
Second Line :
City : ELK CITY
State : OK
Zip : 73644-5200
Country : US
Telephone Number : 405-857-8280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “ PHILLIP MCKINZIE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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