| Wayland W Mckenzie Md Pa | |
|
500 Banner Ave Ste A Greensboro NC 27401-3284 | |
| (336) 273-8638 | |
| (336) 274-0146 |
| Full Name | Wayland W Mckenzie Md Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 500 Banner Ave Ste A, Greensboro, North Carolina |
| Authorized Official Name and Position | Wayland Wilson Mckenzie (PRESIDENT/OWNER) |
| Authorized Official Contact | 3362738638 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayland W Mckenzie Md Pa 500 Banner Ave Ste A Greensboro NC 27401-3284 Ph: (336) 273-8638 | Wayland W Mckenzie Md Pa 500 Banner Ave Ste A Greensboro NC 27401-3284 Ph: (336) 273-8638 |
| NPI Number | 1285865329 |
|---|---|
| Provider Enumeration Date | 08/06/2009 |
| Last Update Date | 05/10/2012 |
| Medicare PECOS PAC ID | 1951440064 |
|---|---|
| Medicare Enrollment ID | O20091203000157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285865329 | NPI | - | NPPES |
| 8957131 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 19760 (North Carolina) | Primary |
| Provider Name | Wayland W Mckenzie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235273509 PECOS PAC ID: 4284520586 Enrollment ID: I20040224000876 |
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