MCKENZIE MEDICAL CENTER, PC; NPI #1225083991

Contact Information

MCKENZIE MEDICAL CENTER, PC

105 N CEDAR ST
GLEASON, TN 38229-7264

Phone: 731-648-5634
Fax: 833-690-3848
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Rural Health	261QR1300X	B4[14]	Rural Health Clinic
Family	363LF0000X	50	Nurse Practitioner
Family Medicine	207Q00000X	08	Physician/Family Practice
Internal Medicine	207R00000X	11	Physician/Internal Medicine
Optometrist	152W00000X	41	Optometry
Physician Assistant	363A00000X	97	Physician Assistant

Indicates primary specialty

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NPI Profile & details for MCKENZIE MEDICAL CENTER, PC

NPI Number 1225083991

LBN Legal business name MCKENZIE MEDICAL CENTER, PC

Authorized official TAMMY ETHERIDGE - (CHIEF OPERATING OFFICER)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/23/2006

Last updated 05/06/2024 - About 2 years ago

Identifiers

TN	License #	APN15541
TN	License #	MD23833
TN	License #	ODT1599
TN	Medicaid	3730458
TN	Other	3380640	GROUP MEDICAID
TN	Other	3380640	MEDICARE GROUP

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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MCKENZIE MEDICAL CENTER, PC

Contact Information

Specialty

Rural Health

Family

Family Medicine

Internal Medicine

Optometrist

Physician Assistant

NPI Profile & details for MCKENZIE MEDICAL CENTER, PC

Reviews for MCKENZIE MEDICAL CENTER, PC