Individual
DR. ROGER E MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1407 W BADDOUR PKWY, LEBANON, TN 37087-2513
(615) 444-6203
(615) 444-6252
Mailing address
1407 W BADDOUR PKWY, LEBANON, TN 37087-2513
(615) 444-6203
(615) 444-6252
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11814
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080157111
MEDICARE RR
TN
01
—
10809852
CAQH
TN
01
—
166465000
WORK COMP
TN
01
—
244555
UHC
TN
01
—
3132332
BCBS
TN
05
—
3180880
—
TN
01
—
4066071
CIGNA
TN
01
—
MD11814
LICENSE
TN
Enumeration date
05/03/2006
Last updated
08/10/2011
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