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Contact Information

MCKINLEY BOATNER, PA
1901 SPRINGLAKE DR
OKLAHOMA CITY, OK73111-5201
 Phone: 405-521-8486
 Fax: 405-521-8496
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MCKINLEY BOATNER · (Male)

NPI # 1508840695
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 12/01/2005
Last updated 10/30/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • OK License # 578
  • OK Medicaid 200013400A
  • OK Medicaid 200013400B
  • OK Medicaid 200013400C
  • OK Other 578 PA LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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