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Individual

WAYLAND WILSON MCKENZIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
500 A BANNER AVE, GREENSBORO, NC 27401-3284
(336) 273-8638
(336) 274-0146
Mailing address
500 A BANNER AVE, GREENSBORO, NC 27401-3284
(336) 273-8638
(336) 274-0146

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
19760
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8957131
NC
Enumeration date
02/19/2007
Last updated
05/03/2012
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