Individual
THOMAS E MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
580 W COLLEGE AVE, MARQUETTE, MI 49855-2705
(906) 225-3406
(906) 225-3094
Mailing address
761 COUNTY ROAD 545 N, SKANDIA, MI 49885-9583
(906) 942-7003
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704207439
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104593293
—
MI
01
—
P00237828
RAILROAD MEDICARE PIN
MI
01
—
TM207439
BLUESHIELD PIN
MI
Enumeration date
11/17/2005
Last updated
04/25/2008
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