Provider Demographics
NPI:1255311452
Name:MCKINNON, ANNE (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:MCKINNON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:247 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062
Mailing Address - Country:US
Mailing Address - Phone:413-586-1754
Mailing Address - Fax:
Practice Address - Street 1:264 ELM ST
Practice Address - Street 2:STES. 10&12
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2857
Practice Address - Country:US
Practice Address - Phone:413-586-1100
Practice Address - Fax:413-584-7062
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA49536207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA14312OtherHEALTH NEW ENGLAND
MA04-2161484OtherNORTH AMERICAN PREFERRED
MA04-2161484OtherPLAN VISTA
MA000000007900OtherBMC
MA04-2161484OtherGREAT-WEST
MA049536OtherTUFTS
MA04-2161484OtherCONSOLIDATED
MA04-2161484OtherNORTHEAST HEALTH DIRECT
MA04-2161484OtherUNICARE/GIC
MA04-2161484OtherNORTHEAST HEALTHCARE ALLI
MA201413OtherHARVARD PILGRIM
MAJ03980OtherBCBS MA
MA04-2161484OtherPRIVATE HEALTHCARE SYSTEM
MA1302469Medicaid
MA10243501OtherCIGNA
MA1430260OtherNEIGHBORHOOD HEALTH PLAN
MA717581OtherCONNECTICARE
MA820769OtherAETNA
MA820769OtherAETNA