Provider Demographics
NPI:1215081708
Name:KINNEY, JAMES B JR (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:KINNEY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:MADIGAN ARMY MEDICAL CTR
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS, MCHJ-P
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1100
Mailing Address - Country:US
Mailing Address - Phone:253-968-1980
Mailing Address - Fax:253-968-0384
Practice Address - Street 1:MADIGAN ARMY MEDICAL CTR
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS, MCHJ-P
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1100
Practice Address - Country:US
Practice Address - Phone:253-968-1980
Practice Address - Fax:253-968-0384
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA025209 MD00024712171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider