Individual
JAMES WAYNE MCKINLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1814 ROSELAND BLVD, TYLER, TX 75701-4234
(903) 526-8754
Mailing address
5701 OLD BULLARD RD,, PMB 56, TYLER, TX 75703-4340
(903) 312-4004
(888) 242-8720
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
H4539
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123027808
—
TX
Enumeration date
10/24/2005
Last updated
06/01/2011
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