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DR. JERRY LAMONT MCKENZIE M.D. NPI 1053679407


NPI Information

NPI: 1053679407
Provider Name: DR. JERRY LAMONT MCKENZIE, M.D.
Classification: Family Medicine - 207QG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

PECOS Registration: Yes

Address:
845 DESCO LN
GRAND PRAIRIE, TX
ZIP 75051
Phone: (817) 761-7876
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DR. Jerry Lamont Mckenzie, M.D. is a geriatric medicine family medicine in Grand Prairie, TX with 12 years of experience. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. DR. Jerry Lamont Mckenzie, M.D. NPI is 1053679407. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduation Year:2012

The provider's business location address is:

845 DESCO LN
GRAND PRAIRIE, TX
ZIP 75051-685
Phone: (817) 761-7876
Fax: (817) 635-6362

The NPI 1053679407 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/23/2012 and was last updated on 5/11/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207P00000XEmergency MedicineE-8969ARKANSASNo
2390200000XStudent in an Organized Health Care Education/Training ProgramNo
3207QG0300XFamily MedicineGeriatric MedicineR4786TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.