MEDICARE: DONALD K MCKENZIE MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD9573	TN

General Provider Information

NPI Number	:	1255505509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONALD K MCKENZIE MD PC

Provider Business Mailing Address
First Line	:	3301 TAZEWELL PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-2532
Country	:	US
Telephone Number	:	865-689-7064
Fax Number	:

Provider Business Practice Location Address
First Line	:	3301 TAZEWELL PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-2532
Country	:	US
Telephone Number	:	865-689-7064
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DONALD KEITH MCKENZIE
Credential	:	MD
Telephone Number	:	865-689-7064

Provider Enumeration Date	:	04/17/2008
Last Update Date	:	04/17/2008

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