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Individual

RICHARD PAUL MCKINLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
116 MINNIE ST, FAIRBANKS, AK 99701-3006
(907) 456-7760
(907) 451-7916
Mailing address
116 MINNIE ST, FAIRBANKS, AK 99701-3006
(907) 456-7760
(907) 451-7916

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
A-131
AK
152W00000X
Optometrist
O-548
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
OD 2131
AK
Enumeration date
10/14/2009
Last updated
08/07/2013
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