Individual
DR. TIMOTHY W. MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 MAGNOLIA WAY, STE. 101, AUGUSTA, GA 30909
(706) 922-6600
(706) 650-0239
Mailing address
PO BOX 2510, EVANS, GA 30809-2510
(706) 922-8251
(706) 922-6695
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
028834
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000428073M
—
GA
01
—
028834
LICENSE
GA
Enumeration date
05/31/2006
Last updated
05/23/2024
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