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General NPI Number Information
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NPI Number | 1194869834
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Entity Type | Organization
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Legal Business Name | MCKENZIE ANESTHESIA GROUP, P.C.
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1462 I ST
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City | SPRINGFIELD
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State | OR
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Zip | 97477-4116
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Country | US
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Telephone | 541-747-8431
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Fax | 541-747-6231
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Provider Business Mailing Address
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Address Line | 1462 I ST
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City | SPRINGFIELD
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State | OR
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Zip | 97477-4116
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Country | US
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Telephone | 541-747-8431
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Fax | 541-747-6231
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CANDACE Y SALES
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Credential |
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Telephone | 541-747-8431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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