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1629040910

NPI Code Detail

MEDICARE: DR. GREGORY GENE MCKENZIE MD

MEDICARE: DR. GREGORY GENE 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	207R00000X	Internal Medicine Physician	F3235	TX
2	208M00000X	Hospitalist Physician	F3235	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110002127	OTHER	TX	RR MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629040910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY GENE MCKENZIE MD

Provider Business Mailing Address
First Line	:	551 HILL COUNTRY DR
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-6085
Country	:	US
Telephone Number	:	830-377-5359
Fax Number	:	830-896-7020

Provider Business Practice Location Address
First Line	:	551 HILL COUNTRY DR
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-6085
Country	:	US
Telephone Number	:	830-377-5359
Fax Number	:	830-896-7020

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	09/23/2009

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Directions to “ DR. GREGORY GENE MCKENZIE MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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