Mckinnon, Debra K

Mckinnon, Debra K is an individual health care provider with primary practice located at 700 S Main St , Moscow ID 83843-3056. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as her primary health care specialty. Mckinnon, Debra K can be contacted via phone (208) 882-4511.

Contact Information

Primary practice address
700 S Main St Moscow ID 83843-3056
Phone: (208) 882-4511
Fax: (208) 883-6580
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X O-126 Idaho

Profile Details

NPI number 1407903669
LBN Legal business name Mckinnon, Debra K
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407903669 NPPES
Idaho Other 000010003680 REGENCE BS ID
Idaho Other B1717 REGENCE BS ID
Idaho MEDICAID 8144412 REGENCE BS ID

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