Provider Demographics
NPI:1841209715
Name:MCKENZIE, DONNA GAIL (MD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:GAIL
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:MCKENZIE
Other - Last Name:LOVE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:318 N FOREST PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5127
Mailing Address - Country:US
Mailing Address - Phone:865-263-2200
Mailing Address - Fax:865-263-2300
Practice Address - Street 1:318 N FOREST PARK BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5127
Practice Address - Country:US
Practice Address - Phone:865-263-2200
Practice Address - Fax:865-263-2300
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN339752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN38247372Medicare PIN
TNH30093Medicare UPIN