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General NPI Number Information
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NPI Number | 1154409472
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Entity Type | Organization
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Legal Business Name | SCOT R. MCKENNA, M.D., P.C.
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 631 NORTHERN BLVD
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City | SOUTH ABINGTON TOWNSHIP
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State | PA
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Zip | 18411-9025
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Country | US
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Telephone | 570-340-6920
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Fax | 570-340-6923
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Provider Business Mailing Address
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Address Line | 631 NORTHERN BLVD
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City | SOUTH ABINGTON TOWNSHIP
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State | PA
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Zip | 18411-9025
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Country | US
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Telephone | 570-340-6920
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Fax | 570-340-6923
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. SCOT ROBERT MCKENNA
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Credential | M.D.
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Telephone | 570-340-6920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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