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General NPI Number Information
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NPI Number | 1538665195
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Entity Type | Individual
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Provider Name | GEORGE JUSTIN MCKENNEY DO
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Gender | Male
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 1040 DELAWARE AVE
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City | MARION
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State | OH
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Zip | 43302-6416
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Country | US
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Telephone | 740-375-8135
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Fax | 740-375-6468
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Provider Business Mailing Address
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Address Line | PO BOX 7527
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City | DUBLIN
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State | OH
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Zip | 43017-0727
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Country | US
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Telephone |
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Fax | 614-544-6370
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 34.017462
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 34.017462
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License Number State | OH
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