Provider Demographics
NPI:1942306253
Name:MCKINLEY, JEFFREY (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:MCKINLEY
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 1:358 CALDWELL ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-2032
Mailing Address - Country:US
Mailing Address - Phone:931-473-2355
Mailing Address - Fax:
Practice Address - Street 1:358 CALDWELL ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-2032
Practice Address - Country:US
Practice Address - Phone:931-473-2355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC717111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0201158OtherBLUE CROSS/BLUE SHIELD TN
TN1370821OtherCIGNA
TN3675586Medicaid
TN3271054OtherAETNA
TNU01900Medicare UPIN
TN3675586Medicare PIN