Provider Demographics
NPI:1710940424
Name:MCKINSEY, JOEL P (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:P
Last Name:MCKINSEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4601 W 109TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1313
Mailing Address - Country:US
Mailing Address - Phone:913-942-0540
Mailing Address - Fax:630-528-9589
Practice Address - Street 1:2340 E MEYER BLVD BLDG 2
Practice Address - Street 2:SUITE 348
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1105
Practice Address - Country:US
Practice Address - Phone:816-444-7977
Practice Address - Fax:630-528-9578
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-28616207RI0200X
MO2000153512207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2087439101Medicaid
KS205061401Medicaid
MO278A555AMedicare Oscar/Certification
MO2087439101Medicaid
KS205061401Medicaid