Provider Demographics
NPI:1730122896
Name:MCKENZIE, WILLIAM DONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DONALD
Last Name:MCKENZIE
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 1:360 PARRISH ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1777
Mailing Address - Country:US
Mailing Address - Phone:585-394-1960
Mailing Address - Fax:585-394-6302
Practice Address - Street 1:360 PARRISH ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1777
Practice Address - Country:US
Practice Address - Phone:585-394-1960
Practice Address - Fax:585-394-6302
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148626207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00708801Medicaid
NY914837001OtherHEALTHNOW
NY6450OtherEXCELLUS ROCHESTER
NY010148626OtherEXCELLUS ROCHESTER
NY0024678OtherGHI
NY102403CUOtherPREFERRED CARE
NY5741449OtherAETNA
13975DMedicare ID - Type Unspecified
NY102403CUOtherPREFERRED CARE