# MCKENZIE ORTHOPEDIC AND SPORTS CLINIC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700943636
- **Authorized official:** JAMES M MCKENZIE M.D. (PRESIDENT)
- **Authorized official phone:** (479) 273-1111

## Contact information

- **Practice address:** 1504 SE 28TH ST, BENTONVILLE, AR 72712-3988
- **Practice address phone:** (479) 273-1111
- **Mailing address:** 1504 SE 28TH ST, BENTONVILLE, AR 72712-3988
- **Mailing address phone:** (479) 273-1111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/02/2007
- **Last updated:** 12/10/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CS8254 | RAILROAD MEDICARE | AR |