Provider Demographics
NPI:1447411921
Name:MCKINNEY, KIBWEI A (MD)
Entity Type:Individual
Prefix:
First Name:KIBWEI
Middle Name:A
Last Name:MCKINNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 NW 9TH ST STE 305
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1073
Mailing Address - Country:US
Mailing Address - Phone:405-272-8435
Mailing Address - Fax:405-272-8438
Practice Address - Street 1:535 NW 9TH ST STE 305
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1073
Practice Address - Country:US
Practice Address - Phone:405-272-8435
Practice Address - Fax:405-272-8438
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK32143207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology