Provider Demographics
NPI:1457794885
Name:MCKINNEY, ROSEKAMAL (MD)
Entity Type:Individual
Prefix:
First Name:ROSEKAMAL
Middle Name:
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13820 N 51ST AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4885
Mailing Address - Country:US
Mailing Address - Phone:602-938-2300
Mailing Address - Fax:
Practice Address - Street 1:13820 N 51ST AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4885
Practice Address - Country:US
Practice Address - Phone:602-938-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ522832083A0300X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics