Provider Demographics
NPI:1134238173
Name:JOSEPH R MCKINLAY MD LLC
Entity type:Organization
Organization Name:JOSEPH R MCKINLAY MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCKINLAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-528-1717
Mailing Address - Street 1:1003 BISHOP ST, PAUAHI TOWER
Mailing Address - Street 2:SUITE #380
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3429
Mailing Address - Country:US
Mailing Address - Phone:808-528-1717
Mailing Address - Fax:808-528-1719
Practice Address - Street 1:1003 BISHOP ST, PAUAHI TOWER
Practice Address - Street 2:SUITE #380
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3429
Practice Address - Country:US
Practice Address - Phone:808-528-1717
Practice Address - Fax:808-528-1719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-10939207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIF69310Medicare UPIN
HIH101970Medicare PIN