Provider Demographics
NPI:1235510462
Name:MCKAY, KENNETH MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:MATTHEW
Last Name:MCKAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HARTWELL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-3118
Mailing Address - Country:US
Mailing Address - Phone:781-890-1023
Mailing Address - Fax:
Practice Address - Street 1:110 HARTWELL AVE STE 101
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-3118
Practice Address - Country:US
Practice Address - Phone:781-890-1023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1014242207W00000X
WAMD60934898207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology