Individual
DR. PATRICK J MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-5753
(920) 593-5555
(920) 445-7289
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
25996-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31480700
—
WI
Enumeration date
06/24/2006
Last updated
01/19/2016
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