Organization
WAYLAND W MCKENZIE MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYLAND WILSON MCKENZIE SR. M.D. (PRESIDENT/OWNER)
(336) 273-8638
Entity
Organization
Contact information
Practice address
500 BANNER AVE STE A, GREENSBORO, NC 27401-3284
(336) 273-8638
(336) 274-0146
Mailing address
500 BANNER AVE STE A, 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
08/06/2009
Last updated
05/10/2012
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