| Doctor Name: | DR. RUSSELL LYNN MCKINLEY |
| NPI Number: | 1063410231 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 280 |
| Business Practice Address: | 708 Westport Rd Suite 102 Elizabethtown, KY - 427013819 |
| Business Phone Number: | 2707691303 |
| Business Fax Number: | 2707691310 |
| Mailing Address: | P.o. Box 6188, ELIZABETHTOWN |
| State: | KY |
| Postal Code: | 427026188 |
| Phone Number: | 2707691303 |
| Fax Number: | 2707691310 |
| NPI Enumeration Date: | 07/12/2005 |
| NPI Last Update Date: | 07/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 280 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |