Organization
KEITH C MCKENZIE MD PLLC
Active
Other names
The Family Doctor
Organization subpart
No
Provider details
NPI number
Authorized official
TINA WILLIAMS (OFFICE MANAGER)
(586) 286-9720
Entity
Organization
Contact information
Practice address
15501 METROPOLITAN PKWY, SUITE 110, CLINTON TWP, MI 48036-1684
(586) 286-9720
(586) 286-3134
Mailing address
15501 METROPOLITAN PKWY, SUITE 110, CLINTON TWP, MI 48036-1684
(586) 286-9720
(586) 286-3134
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301067883
MI
207Q00000X
Family Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
5601002587
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E02201
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/05/2007
Last updated
12/21/2016
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