Provider Demographics
NPI:1205870730
Name:MCKENZIE, WILLIAM F (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:MCKENZIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:95-119 KAM HWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-3393
Mailing Address - Country:US
Mailing Address - Phone:808-623-2212
Mailing Address - Fax:808-625-2917
Practice Address - Street 1:95-119 KAM HWY
Practice Address - Street 2:SUITE A
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-3393
Practice Address - Country:US
Practice Address - Phone:808-623-2212
Practice Address - Fax:808-625-2917
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIE04189207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI042822Medicaid
HI042822Medicaid
HI0000BDGQRMedicare ID - Type Unspecified