Provider Demographics
NPI:1104186337
Name:MCKENZIE, KARLA PYLE (AUD)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:PYLE
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 COMMERCIAL DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3625
Mailing Address - Country:US
Mailing Address - Phone:912-355-2335
Mailing Address - Fax:912-355-2301
Practice Address - Street 1:128 FRANCES MEEKS WAY STE 1
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3984
Practice Address - Country:US
Practice Address - Phone:912-445-4710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD001397231H00000X, 237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003152506GMedicaid
GA202I642114Medicare PIN