Individual
LARRY D. MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4716 W URBANA ST STE 200, BROKEN ARROW, OK 74012-6162
(918) 710-4112
(918) 710-4118
Mailing address
4716 W URBANA ST STE 200, BROKEN ARROW, OK 74012-6162
(918) 710-4112
(918) 710-4118
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
3116
OK
207Q00000X
Family Medicine Physician
3116
OK
208VP0014X
Interventional Pain Medicine Physician
Primary
3116
OK
Other
Enumeration date
03/17/2006
Last updated
07/06/2021
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