Provider Demographics
NPI:1639120678
Name:MCKINNEY, SHAUNA LEIGH (MD)
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:LEIGH
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 1:115 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-4044
Mailing Address - Country:US
Mailing Address - Phone:918-584-2870
Mailing Address - Fax:918-587-3602
Practice Address - Street 1:115 E 15TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-4044
Practice Address - Country:US
Practice Address - Phone:918-584-2870
Practice Address - Fax:918-587-3602
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK26768207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKI19025Medicare UPIN