Provider Demographics
NPI:1730159385
Name:MCKINNON, JONATHAN H (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:H
Last Name:MCKINNON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:351 N BUFFALO DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-0301
Mailing Address - Country:US
Mailing Address - Phone:702-505-4230
Mailing Address - Fax:702-505-4231
Practice Address - Street 1:7575 W WASHINGTON AVE
Practice Address - Street 2:SUITE 127-160
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4333
Practice Address - Country:US
Practice Address - Phone:702-505-4230
Practice Address - Fax:702-505-4231
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2023-09-06
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Provider Licenses
StateLicense IDTaxonomies
NV141372084N0008X, 2084N0400X
AZ360352084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine