# JOHN D MACKENNEY PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Space Coast Foot & Ankle Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841472479
- **Authorized official:** DR. JOHN DAVID MACKENNEY DPM (OWNER PHYSICIAN)
- **Authorized official phone:** (321) 259-4268

## Contact information

- **Practice address:** 6550 N WICKHAM RD STE 4, MELBOURNE, FL 32940-2038
- **Practice address phone:** (321) 259-4268
- **Mailing address:** 6550 N WICKHAM RD STE 4, MELBOURNE, FL 32940-2038
- **Mailing address phone:** (321) 259-4268

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO3043 | FL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 12/05/2007
- **Last updated:** 08/09/2011