Provider Demographics
NPI:1356440069
Name:MCKINNON, STUART JAMES (MD, PHD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:JAMES
Last Name:MCKINNON
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DUKE UNIVERSITY EYE CTR
Mailing Address - Street 2:BOX 3802 ERWIN ROAD
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-684-2975
Mailing Address - Fax:919-681-8267
Practice Address - Street 1:DUKE UNIVERSITY EYE CTR
Practice Address - Street 2:BOX 3802 ERWIN ROAD
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-2975
Practice Address - Fax:919-681-8267
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-1372207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCF02161Medicare UPIN