Provider Demographics
NPI:1417911017
Name:KINNEY, JAMES RAYMOND SR (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RAYMOND
Last Name:KINNEY
Suffix:SR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:10225 ULMERTON RD
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3538
Mailing Address - Country:US
Mailing Address - Phone:727-581-4849
Mailing Address - Fax:727-584-7429
Practice Address - Street 1:2780 E BAY DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-2469
Practice Address - Country:US
Practice Address - Phone:727-535-3489
Practice Address - Fax:727-535-3585
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2008-03-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS4164207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL82332OtherBLUE CROSS BLUE SHIELD
FL82332BMedicare PIN
E32206Medicare UPIN