National Provider Identifier Database

MCKENZIE MEDICAL CENTER PC
Rural Health


Contact Information

MCKENZIE MEDICAL CENTER, PC
811 MORROW ST STE 207
DRESDEN, TN38225-1847
Phone: 731-364-4900
Fax: 833-690-3848
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X
Clinic/Center 261Q00000X
Family 363LF0000X
Family Medicine 207Q00000X
Optometrist 152W00000X
Physician Assistant 363A00000X

* Indicates primary specialty

NPI Profile & details for MCKENZIE MEDICAL CENTER, PC

NPI Number 1609101534
Legal business name
LBN
MCKENZIE MEDICAL CENTER, PC
Authorized official TAMMY ETHERIDGE - (CHIEF OPERATING OFFICER)
Entity Organization
Organization subpart No
Enumeration date 10/09/2009
Last updated 05/06/2024 - About 2 years ago
Sole proprietor1 Not specified
Identifiers
  • TN License #: APN14751
  • TN License #: MD23833
  • TN License #: ODT1599
  • TN License #: PA1262
  • TN Medicaid: Q018764
  • TN Other: 3380640 GROUP MEDICAID NUMBER
  • TN Other: 3380640 GROUP MEDICARE NUMBER

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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