1306877402 NPI number — MCKENZIE HEALTHCARE SOLUTIONS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306877402 NPI number — MCKENZIE HEALTHCARE SOLUTIONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCKENZIE HEALTHCARE SOLUTIONS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306877402
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 HARRISON STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAYETTE
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39069
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-304-0339
Provider Business Mailing Address Fax Number:
601-304-0255

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
135 HIGHWAY 61 S STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATCHEZ
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39120-5216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-304-0339
Provider Business Practice Location Address Fax Number:
607-304-0255
Provider Enumeration Date:
07/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCKENZIE
Authorized Official First Name:
SHEDRICK
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
601-304-0339

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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