Provider Demographics
NPI:1164439121
Name:MCKINNELL, JAMES VANCE (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:VANCE
Last Name:MCKINNELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:DEPARTMENT OF PEDIATRICS MSC10 5590
Mailing Address - Street 2:1 UNIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-4461
Mailing Address - Fax:505-272-8699
Practice Address - Street 1:DEPARTMENT OF PEDIATRICS MSC10 5590
Practice Address - Street 2:1 UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-4461
Practice Address - Fax:505-272-8699
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2009-08-10
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Provider Licenses
StateLicense IDTaxonomies
NM2001-2542080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology