Individual
DWIGHT LAWRENCE MCKENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1827 GENTILLY BLVD, NEW ORLEANS, LA 70119-2051
(504) 943-1923
(504) 943-1933
Mailing address
4433 TCHOUPITOULAS ST, NEW ORLEANS, LA 70115-1554
(504) 899-1056
(504) 899-1954
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
03347R
LA
208D00000X
General Practice Physician
Primary
MD03347R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1129267
—
LA
01
—
F4229
BLUE CROSS/BLUE SHIELD
LA
01
—
UP4206
UNITED HEALTHCARE
LA
Enumeration date
08/30/2006
Last updated
06/18/2008
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