Mckenzie, Stacey W

Mckenzie, Stacey W is an individual health care provider with primary practice located at 2151 Century Ln , Johnson City TN 37604-4469. She recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as her primary health care specialty. Mckenzie, Stacey W can be contacted via phone (423) 926-2500.

Contact Information

Primary practice address
2151 Century Ln Johnson City TN 37604-4469
Fax: (423) 926-5999
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 18756 Tennessee

Profile Details

NPI number 1699768101
LBN Legal business name Mckenzie, Stacey W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated May 3rd, 2017 - about 9 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 1699768101 NPPES
Tennessee MEDICAID Q010241

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