Organization
MELISSA A. MCKINNEY, D.O., P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA A. MCKINNEY D.O. (PHYSICIAN)
(928) 592-9140
Entity
Organization
Contact information
Practice address
4283 PIMA WAY, LAKE MONTEZUMA, AZ 86342-5087
(928) 592-9140
(928) 592-9144
Mailing address
2370 W HWY 89A #11 PMB 412, SEDONA, AZ 86336-5341
(928) 592-9140
(928) 592-9144
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
4057
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z104516
MEDICARE GROUP NUMBER
AZ
Enumeration date
03/10/2008
Last updated
03/14/2008
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