Provider Demographics
NPI:1982362224
Name:MKY HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:MKY HEALTHCARE SERVICES LLC
Other - Org Name:EASY HEALTHCARE ONLINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:KINARD
Authorized Official - Last Name:YAWN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:229-886-9139
Mailing Address - Street 1:1380 US HIGHWAY 41
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:GA
Mailing Address - Zip Code:31092-7744
Mailing Address - Country:US
Mailing Address - Phone:229-598-0595
Mailing Address - Fax:206-471-6113
Practice Address - Street 1:1380 US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:GA
Practice Address - Zip Code:31092-7744
Practice Address - Country:US
Practice Address - Phone:229-598-0595
Practice Address - Fax:206-471-6113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-03
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty