Basic Information
| Provider Information | |||||||||
| NPI: | 1750701561 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BINKLEY | ||||||||
| FirstName: | MCKELLAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 48 CASA LOMA RD | ||||||||
| Address2: | |||||||||
| City: | CEDAR CREST | ||||||||
| State: | NM | ||||||||
| PostalCode: | 870089435 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 475 W 940 N | ||||||||
| Address2: | |||||||||
| City: | PROVO | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846043301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8013577926 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2014 | ||||||||
| LastUpdateDate: | 10/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 9498520-1205 | UT | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 9498520-1205 | UT | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.