Provider Demographics
NPI:1659346625
Name:MCKENZIE, WILLIAM M (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:MCKENZIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-878-2260
Mailing Address - Fax:336-878-2277
Practice Address - Street 1:501 HICKORY BRANCH DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-9601
Practice Address - Country:US
Practice Address - Phone:336-878-2260
Practice Address - Fax:336-878-2277
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2013-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC20166207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC80160290OtherRAILROAD MEDICARE NUMBER
NC8956881Medicaid
NC6905007003OtherCIGNA HEALTHCARE NUMBER
NC8222OtherPARTNERS MEDICARE CHOICE
NC56881OtherBCBS NUMBER
NC4613661OtherAETNA
NC6607458OtherUNITED HEALTHCARE NUMBER
NC291930OtherMAMSI NUMBER
NC72973OtherMEDCOST NUMBER
NC2202668DMedicare PIN
NC6905007003OtherCIGNA HEALTHCARE NUMBER
NC8956881Medicaid