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Organization
JOHN D MACKENNEY PA
Active
Organization
JOHN D MACKENNEY PA
Active
Other names
Space Coast Foot & Ankle Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DAVID MACKENNEY DPM (OWNER PHYSICIAN)
(321) 259-4268
Entity
Organization
Contact information
Practice address
6550 N WICKHAM RD STE 4, MELBOURNE, FL 32940-2038
(321) 259-4268
Mailing address
6550 N WICKHAM RD STE 4, MELBOURNE, FL 32940-2038
(321) 259-4268
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3043
FL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
12/05/2007
Last updated
08/09/2011
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