Provider Demographics
NPI:1295724771
Name:MCKINNEY, MICHAEL EUGENE (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EUGENE
Last Name:MCKINNEY
Suffix:
Gender:M
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:UK DIV OF CARDIOLOGY
Mailing Address - Street 2:900 S. LIMESTONE, CTW320
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0200
Mailing Address - Country:US
Mailing Address - Phone:859-323-3976
Mailing Address - Fax:859-257-6060
Practice Address - Street 1:349 BOGLE STREET, SUITE A
Practice Address - Street 2:LAKE CUMBERLAND CARDIOLOGY ASSOCIATES
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503
Practice Address - Country:US
Practice Address - Phone:606-678-0599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25453207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051121719OtherBCBS
AL132373Medicaid
ALD32848OtherVIVA
AL051121718OtherBCBS
AL051121720OtherBCBS
AL132369Medicaid
AL132371Medicaid
AL051121717OtherBCBS
AL132372Medicaid
MS06352291Medicaid
AL051121719OtherBCBS
AL132369Medicaid