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Individual
DWIGHT LAWRENCE MCKENNA
Active
Individual
DWIGHT LAWRENCE MCKENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
03347R
LA
208D00000X
General Practice Physician
Primary
MD03347R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1129267
—
LA
01
—
F4229
BLUE CROSS/BLUE SHIELD
LA
01
—
UP4206
UNITED HEALTHCARE
LA
Enumeration date
08/30/2006
Last updated
06/18/2008
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