Provider Demographics
NPI:1285953067
Name:MCKINNEY, DAVID WALTER (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WALTER
Last Name:MCKINNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2055
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-2055
Mailing Address - Country:US
Mailing Address - Phone:530-534-5135
Mailing Address - Fax:530-532-0259
Practice Address - Street 1:1940 FEATHER RIVER BLVD
Practice Address - Street 2:SUITE# N&O
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-5723
Practice Address - Country:US
Practice Address - Phone:530-534-5135
Practice Address - Fax:530-532-0259
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG54844202C00000X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA25804Medicare UPIN