Mark Kelly McKain, MD

Individual provider Active NPI Surgery Physician · Twin Falls, ID

NPI 1801907324 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1801907324
Entity type
Individual (NPI type 1)
Primary specialty
Surgery Physician 208600000X
License
M6053 (ID)
Practice address
253 Martin Street
Twin Falls, ID 83301-4532
Phone
(208) 733-0482
Fax
(208) 734-0263
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M6053IDMDSurgery Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X M6053 ID Yes

Addresses

Primary practice location

253 Martin Street
Twin Falls, ID 83301-4532

Mailing address

253 Martin Street
Twin Falls, ID 83301-4532
Phone (208) 733-0482

Other providers in Twin Falls, ID

All providers in Twin Falls, ID · Surgery Physician in Idaho

Sources for this page

Verify at the official NPI Registry.