Individual
DR. JOHN WADE MCKINNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
437 HULSEY RD, BOURBON, MO 65441-8159
(573) 732-3499
(573) 732-3499
Mailing address
437 HULSEY RD, BOURBON, MO 65441-8159
(573) 732-3499
(573) 732-3499
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
R6B87
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040009014
RAILROAD MEDICARE
—
Enumeration date
04/13/2006
Last updated
11/20/2009
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