Provider Demographics
NPI:1245245992
Name:MCKINLAY, RODRICK D (MD)
Entity Type:Individual
Prefix:
First Name:RODRICK
Middle Name:D
Last Name:MCKINLAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1521 E 3900 S STE 100
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1550
Mailing Address - Country:US
Mailing Address - Phone:801-268-3800
Mailing Address - Fax:801-268-3997
Practice Address - Street 1:1521 E 3900 S STE 100
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1550
Practice Address - Country:US
Practice Address - Phone:801-268-3800
Practice Address - Fax:801-268-3997
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT56697411205208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery