Provider Demographics
NPI:1588640965
Name:KINNEY, KAREN K (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:K
Last Name:KINNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1122 NE 13TH ST
Mailing Address - Street 2:ORI 236
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-1039
Mailing Address - Country:US
Mailing Address - Phone:405-271-1515
Mailing Address - Fax:
Practice Address - Street 1:711 STANTON L YOUNG BLVD
Practice Address - Street 2:PPB SUITE 430
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5023
Practice Address - Country:US
Practice Address - Phone:405-271-5068
Practice Address - Fax:405-271-6434
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA34096207RI0200X, 2083P0011X
OK20283207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA71708OtherCOVENTRY
IA0233130Medicaid
IA2064339OtherUNITED HEALTHCARE
IA27585OtherWELLMARK
IAIA0137OtherUHC OF THE RIVER VALLEY
IA232977OtherMIDLAND'S CHOICE
IAIA0137OtherUHC OF THE RIVER VALLEY
IA2064339OtherUNITED HEALTHCARE