Provider Demographics
NPI:1275504730
Name:EL-KALLINY, MAGDY M (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDY
Middle Name:M
Last Name:EL-KALLINY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:330 SEVEN SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5098
Mailing Address - Country:US
Mailing Address - Phone:915-920-7905
Mailing Address - Fax:615-920-8935
Practice Address - Street 1:75 HAIL KNOB RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-3434
Practice Address - Country:US
Practice Address - Phone:606-678-9617
Practice Address - Fax:606-678-9619
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY31399207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY163996100OtherFEDERAL BLACK LUNG
KY000000051252OtherBCBS PIN #
KY643113992Medicaid
KY140003830OtherRR MCARE
KYUMWAOther1508291
KY643113992Medicaid
KY140003830OtherRR MCARE