Provider Demographics
NPI:1609849033
Name:MCKINNEY, DAHLIA H (MD)
Entity Type:Individual
Prefix:
First Name:DAHLIA
Middle Name:H
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 9TH AVE SW
Mailing Address - Street 2:SUITE 305
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-4527
Mailing Address - Country:US
Mailing Address - Phone:205-481-8525
Mailing Address - Fax:205-481-8528
Practice Address - Street 1:995 9TH AVE SW
Practice Address - Street 2:SUITE 305
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-4527
Practice Address - Country:US
Practice Address - Phone:205-481-8525
Practice Address - Fax:205-481-8528
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39614174400000X, 208M00000X
AL29940174400000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64115256Medicaid
KYP00426399OtherRAILROAD MEDICARE
KYI44157Medicare UPIN
KY64115256Medicaid
KY3403743Medicare PIN