Individual
KIRT M MCKINLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1441 PARKWAY DR, BLACKFOOT, ID 83221-1667
(208) 785-2600
Mailing address
1441 PARKWAY DR, BLACKFOOT, ID 83221-1667
(208) 785-2600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-4895
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002331100
—
ID
Enumeration date
05/31/2006
Last updated
05/15/2008
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