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Organization
MCKENNA GENERAL MEDICAL, LLC
Active
Organization
MCKENNA GENERAL MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT LAWRENCE MCKENNA M.D. (PRESIDENT/PHYSICIAN)
(504) 943-1923
Entity
Organization
Contact information
Practice address
1827 GENTILLY BLVD, NEW ORLEANS, LA 70119-2051
(504) 943-1923
(504) 943-1933
Mailing address
1827 GENTILLY BLVD, NEW ORLEANS, LA 70119-2051
(504) 943-1923
(504) 943-1933
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1129267
—
LA
01
—
436664206B
BLUE CROSS/BLUE SHIELD
LA
01
—
F4229
BLUE CROSS/BLUE SHIELD
LA
01
—
UP4206
UNITED HEALTHCARE
LA
Enumeration date
06/18/2008
Last updated
08/12/2011
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