Mckenzie, Mark M

Mckenzie, Mark M is an sole proprietor health care provider with primary practice located at 6031 Shallowford Rd Suite 105, Chattanooga TN 37421-1983. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mckenzie, Mark M can be contacted via phone (423) 468-3923.

Contact Information

Primary practice address
6031 Shallowford Rd Suite 105 Chattanooga TN 37421-1983
Phone: (423) 468-3923
Fax: (423) 468-3927
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35982 Tennessee

Profile Details

NPI number 1821064122
LBN Legal business name Mckenzie, Mark M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 27th, 2006
Last updated Dec 30th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821064122 NPPES
Tennessee Other 4158363 BCBS
Tennessee Other 4178417 BCBS
Tennessee MEDICAID 38720281 BCBS

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