Provider Demographics
NPI:1861571614
Name:MCKINNEY, JAMES A (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:MCKINNEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5009 UNIVERSITY AVE
Mailing Address - Street 2:STE C
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-4432
Mailing Address - Country:US
Mailing Address - Phone:254-634-6999
Mailing Address - Fax:254-200-4099
Practice Address - Street 1:3201 S AUSTIN AVE
Practice Address - Street 2:STE 255
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7545
Practice Address - Country:US
Practice Address - Phone:512-763-4325
Practice Address - Fax:512-763-4324
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN3174208D00000X, 208D00000X, 207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX275004YYNOtherMEDICARE
TX287944701Medicaid
TXTXB142196Medicare Oscar/Certification