Mckinnie, Tiffany

Mckinnie, Tiffany is an individual health care provider with primary practice located at 1000 Medical Center Blvd , Lawrenceville GA 30046-7694. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Mckinnie, Tiffany can be contacted via phone (678) 312-4416.

Contact Information

Primary practice address
1000 Medical Center Blvd Lawrenceville GA 30046-7694
Phone: (678) 312-4416
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 054623 Georgia
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 54623 Georgia

Profile Details

NPI number 1083713028
LBN Legal business name Mckinnie, Tiffany
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated Sep 6th, 2013 - about 13 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 1083713028 NPPES
Georgia MEDICAID 164512785C

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