Individual
LLOYD MARK MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
436 5TH & TED STEVENS WAY, KOTZEBUE, AK 99752-0043
(907) 442-3321
(907) 442-7250
Mailing address
5210 CLEVELAND BLVD, STE 140-214, CALDWELL, ID 83607-1796
(541) 231-4627
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2160
AK
363A00000X
Physician Assistant
C04190
MD
363A00000X
Physician Assistant
PA735
ID
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HS19IP
—
AK
05
—
HS19OP
—
AK
Enumeration date
08/11/2007
Last updated
12/02/2011
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