Individual
MR. MARK MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1130 MIDDLE CREEK RD., STE. 260, SEVIERVILLE, TN 37862
(865) 428-7586
Mailing address
1130 MIDDLE CREEK RD., STE. 260, SEVIERVILLE, TN 37862
(865) 428-7586
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2690
TN
363AM0700X
Medical Physician Assistant
2690
TN
363AS0400X
Surgical Physician Assistant
2690
TN
Other
Enumeration date
12/23/2014
Last updated
12/23/2014
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