Individual
DR. CARL K MCKENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2306 RIDGE RD, ROCKWALL, TX 75087-5140
(972) 771-8316
(972) 722-9214
Mailing address
2306 RIDGE RD, ROCKWALL, TX 75087-5140
(972) 771-8316
(972) 722-9214
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D5793
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084483901
—
TX
05
—
084483902
—
TX
05
—
123629102
—
TX
05
—
123629105
—
TX
Enumeration date
09/20/2005
Last updated
03/26/2010
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