MEDICARE: DR. KAY Q. MCKENZIE MD

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	2084P0800X	Psychiatry Physician	35038548	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669541991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAY Q. MCKENZIE MD

Provider Business Mailing Address
First Line	:	1611 SO GREEN RD
Second Line	:	SUITE 302
City	:	CLEVELAND
State	:	OH
Zip	:	44121-4192
Country	:	US
Telephone Number	:	216-691-9420
Fax Number	:	216-297-3161

Provider Business Practice Location Address
First Line	:	1611 SO GREEN RD
Second Line	:	SUITE 302
City	:	CLEVELAND
State	:	OH
Zip	:	44121-4192
Country	:	US
Telephone Number	:	216-691-9420
Fax Number	:	216-297-3161

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	04/23/2012

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