Individual
DR. RUSSELL LYNN MCKINLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
708 WESTPORT RD, SUITE 102, ELIZABETHTOWN, KY 42701-3819
(270) 769-1303
(270) 769-1310
Mailing address
P.O. BOX 6188, ELIZABETHTOWN, KY 42702-6188
(270) 769-1303
(270) 769-1310
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
280
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000300214
ANTHEM
KY
01
—
50002169
PASSPORT
KY
01
—
618577
WELLCARE MEDICAID
KY
05
—
80000383
—
KY
01
—
P00068624
RAILROAD MEDICARE
KY
Enumeration date
07/12/2005
Last updated
07/21/2014
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