Individual
EDWARD BURT MCKENZIE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1211 VIRGINIA ST, GREENSBORO, NC 27401-1313
(336) 272-0101
(336) 809-3001
Mailing address
PO BOX 29343, GREENSBORO, NC 27429-9343
(336) 272-0101
(336) 809-3001
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
30880
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8957111
—
NC
Enumeration date
07/19/2006
Last updated
07/08/2007
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