Provider Demographics
NPI:1972801744
Name:MCKINLEY, JOHN AARON (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:AARON
Last Name:MCKINLEY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 MARYLAND CIR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3800
Mailing Address - Country:US
Mailing Address - Phone:703-939-5213
Mailing Address - Fax:
Practice Address - Street 1:552A LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-1635
Practice Address - Country:US
Practice Address - Phone:610-644-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110003281363A00000X
PAMA003113L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant