Provider Demographics
NPI:1629131040
Name:MCKINNON, MURRAY (DC)
Entity Type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:
Last Name:MCKINNON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 MILL BRANCH LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37938-3260
Mailing Address - Country:US
Mailing Address - Phone:865-922-1476
Mailing Address - Fax:865-922-2068
Practice Address - Street 1:4605 MILL BRANCH LANE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37938
Practice Address - Country:US
Practice Address - Phone:865-922-1476
Practice Address - Fax:865-922-2068
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7984176111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC499178Medicare ID - Type Unspecified