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NPI Code Detail

MEDICARE: DR. GEORGE JOSEPH MCKENNA M.D.

MEDICARE: DR. GEORGE JOSEPH MCKENNA M.D.
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
12084N0400XNeurology PhysicianD0057358MD
22083A0100XAerospace Medicine PhysicianD0057358MD

General Provider Information

NPI Number : 1417930017
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE JOSEPH MCKENNA M.D.
Provider Business Mailing Address
First Line : VETERANS AFFAIRS MEDICAL CTR
Second Line : 50 IRVING STREET, N.W.
City : WASHINGTON
State : DC
Zip : 20422-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : VETERANS AFFAIRS MEDICAL CTR
Second Line : 50 IRVING STREET, N.W.
City : WASHINGTON
State : DC
Zip : 20422-0001
Country : US
Telephone Number : 202-745-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2005
Last Update Date : 04/05/2012

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