Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 120532 | DC |
N | 208600000X | Surgeon | 120532 | DC |
N | 208200000X | Surgeon | 246060 | MA |
N | 208600000X | Surgeon | 246060 | MA |
Y | 2086X0206X | Surgical Oncologist | 50400 | TN |
NPI | 1245410547 |
---|---|
Provider Name | Dr. Tamra Suzanne Mckenzie |
First Address | Mountain Home, TN 37684-0699 |
Second Address | Johnson City, TN 37604-6056 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2007 |
Last Update Date | 11/09/2013 |