Basic Information
| Provider Information | |||||||||
| NPI: | 1477580561 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCKINNEY | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | BENJAMIN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 KIRTS BLVD | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480844134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104680800 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4800 FREDERICKSBURG RD STE 127 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293781 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104680800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 04/19/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | J6583 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | 208600000X | ME88012 | FL | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | J6583 | TX | N | Allopathic & Osteopathic Physicians | Surgery | 207P00000X | J6583 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.