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Individual

DR. BROCK L MCKAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
7807 E FUNSTON ST, WICHITA, KS 67207-3123
(316) 636-1188
(316) 636-1190
Mailing address
7807 E FUNSTON ST, WICHITA, KS 67207-3123
(316) 636-1188
(316) 636-1190

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0904
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
119800
BCBS PROVIDER NUMBER
KS
01
4589
PREFERRED HEALTH SYSTEMS
KS
01
63173
PREMIERE BLUE ID
KS
Enumeration date
07/26/2006
Last updated
02/11/2009
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