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Contact Information

JERRY L MCKENZIE, MD
1720 E BROAD ST
MANSFIELD, TX76063-3400
 Phone: 817-453-5912
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for JERRY L MCKENZIE · (Male)

NPI Number 1053679407
Status Active
Credentials MD
Entity Individual
Enumeration date 04/23/2012
Last updated 12/11/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • AR License # E-8969
  • TX License # R4786
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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