Individual
DR. TERENCE P MCKENNA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9217 US HIGHWAY 42, PROSPECT, KY 40059-8858
(502) 228-1312
Mailing address
9217 US HIGHWAY 42, PROSPECT, KY 40059-8858
(502) 228-1312
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22052
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1049487
PASSPORT
KY
05
—
64220428
—
KY
Enumeration date
01/16/2006
Last updated
07/08/2007
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