Provider Demographics
NPI:1154978500
Name:MCKINNEY, ANTHONY QUANDREZ
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:QUANDREZ
Last Name:MCKINNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1314
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202
Mailing Address - Country:US
Mailing Address - Phone:256-689-6870
Mailing Address - Fax:
Practice Address - Street 1:602 LANE ROAD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203
Practice Address - Country:US
Practice Address - Phone:256-452-8270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider