Doctor Name: | JAMES M. MCKENZIE |
NPI Number: | 1043346026 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | PA9101307 |
Business Practice Address: | 5711 Eaglemount Cir Lithia, FL - 335473852 |
Business Phone Number: | 8136611144 |
Business Fax Number: | |
Mailing Address: | 5711 Eaglemount Cir, LITHIA |
State: | FL |
Postal Code: | 335473852 |
Phone Number: | 8136611144 |
Fax Number: | |
NPI Enumeration Date: | 02/26/2007 |
NPI Last Update Date: | 10/15/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | PA9101307 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |