Individual
MR. KENNETH CHANDLER MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1401 W 5TH ST, SHERIDAN, WY 82801-2705
(307) 672-1161
(307) 672-2791
Mailing address
1401 W 5TH ST, SHERIDAN, WY 82801-2705
(307) 672-1161
(307) 672-2791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA - 1194
ID
363A00000X
Physician Assistant
PA176761
OR
363A00000X
Physician Assistant
Primary
PA728
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147317400
—
WY
Enumeration date
09/29/2014
Last updated
10/20/2025
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