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NPI Code Detail

MEDICARE: MATTHEW W MCKINLEY MD

MEDICARE: MATTHEW W 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
1207X00000XOrthopaedic Surgery Physician98-115NM

Other Identifiers

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

General Provider Information

NPI Number : 1720025737
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW W MCKINLEY MD
Provider Business Mailing Address
First Line : 5901 HARPER DR
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87109-3587
Country : US
Telephone Number : 505-823-8556
Fax Number : 505-823-8555
Provider Business Practice Location Address
First Line : 1010 SPUCE ST
Second Line :
City : ESPANOLA
State : NM
Zip : 87532-3456
Country : US
Telephone Number : 505-753-7111
Fax Number : 505-753-4438
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 01/25/2012

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