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NPI Code Detail

MEDICARE: MACKENZIE SOCKWELL NRP

MEDICARE: MACKENZIE SOCKWELL NRP
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
1146L00000XParamedicP033213

General Provider Information

NPI Number : 1417807447
Entity Type Code : Individual
Provider Name (Legal Business Name) : MACKENZIE SOCKWELL NRP
Provider Business Mailing Address
First Line : 4141 KALB CT SW
Second Line :
City : SMYRNA
State : GA
Zip : 30082-4446
Country : US
Telephone Number : 706-974-5715
Fax Number :
Provider Business Practice Location Address
First Line : 4141 KALB CT SW
Second Line :
City : SMYRNA
State : GA
Zip : 30082-4446
Country : US
Telephone Number : 706-974-5715
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2026
Last Update Date : 01/29/2026

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Directions to “ MACKENZIE SOCKWELL NRP” Practice Location

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