| Organization Name: | MCKENNA GENERAL MEDICAL, LLC |
| NPI Number: | 1164683645 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DWIGHT LAWRENCE MCKENNA (PRESIDENT/PHYSICIAN) |
| Mailing Address: | 1827 Gentilly Blvd New Orleans |
| State: | LA US |
| Postal Code: | 701192051 |
| Phone Number: | 5049431923 |
| Fax Number: | 5049431933 |
| NPI Enumeration Date: | 06/18/2008 |
| NPI Last Update Date: | 08/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |