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NPI Code Detail

MEDICARE: SENOCARE LLC

MEDICARE: SENOCARE LLC
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
12085R0202XDiagnostic Radiology Physician
22083X0100XOccupational Medicine Physician

General Provider Information

NPI Number : 1780536730
Entity Type Code : Organization
Provider Name (Legal Business Name) : SENOCARE LLC
Provider Business Mailing Address
First Line : 3060 PEACHTREE RD NW STE 140
Second Line :
City : ATLANTA
State : GA
Zip : 30305-2234
Country : US
Telephone Number : 470-749-9997
Fax Number : 470-749-9933
Provider Business Practice Location Address
First Line : 3060 PEACHTREE RD NW STE 140
Second Line :
City : ATLANTA
State : GA
Zip : 30305-2234
Country : US
Telephone Number : 470-749-9997
Fax Number : 470-749-9933
Authorized Official
Title or Position : FOUNDER
Name : DR. STANTON MARK MCKENNA
Credential : MD
Telephone Number : 504-451-5665
Provider Enumeration Date : 02/12/2026
Last Update Date : 02/12/2026

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Directions to “SENOCARE LLC ” Practice Location

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