Provider Demographics
NPI:1801107099
Name:MCKINNEY, JAMES SAN (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SAN
Last Name:MCKINNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1739 E BEVERLY AVE
Mailing Address - Street 2:STE. 200
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3593
Mailing Address - Country:US
Mailing Address - Phone:928-263-4547
Mailing Address - Fax:928-263-4794
Practice Address - Street 1:3104 N STOCKTON HILL RD
Practice Address - Street 2:MOHAVE SURGICAL SPECIALISTS
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-4183
Practice Address - Country:US
Practice Address - Phone:928-681-8720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ51001208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery