Basic Information
Provider Information
NPI: 1558599076
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCKINNEY
FirstName: CHRISTOPHER
MiddleName: MICHAEL
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13123 E 16TH AVE # B115
Address2:  
City: AURORA
State: CO
PostalCode: 800457106
CountryCode: US
TelephoneNumber: 7207776740
FaxNumber:  
Practice Location
Address1: 13123 E 16TH AVE # B115
Address2:  
City: AURORA
State: CO
PostalCode: 800457106
CountryCode: US
TelephoneNumber: 7207776740
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/23/2009
LastUpdateDate: 08/28/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X003593GAN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0207XDR.0050718COY Allopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology

No ID Information.


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