Individual
JOHN J MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6366
Mailing address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6366
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
61489
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174881064
—
WI
Enumeration date
04/27/2012
Last updated
12/11/2020
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