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Organization
LODI ORTHOPAEDIC MEDICAL GROUP
Active
Organization
LODI ORTHOPAEDIC MEDICAL GROUP
Active
Other names
Thomas P McKenzie MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS PETER MCKENZIE MD (PRESIDENT)
(209) 334-2590
Entity
Organization
Contact information
Practice address
924 S FAIRMONT AVE, LODI, CA 95240-5119
(209) 334-2590
(209) 334-0944
Mailing address
924 S FAIRMONT AVE, LODI, CA 95240-5119
(209) 334-2590
(209) 334-0944
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200008575
RAILROAD MEDICARE
CA
05
—
GR0029390
—
CA
Enumeration date
10/12/2005
Last updated
04/25/2008
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