Dr. Kenneth L McRae, DC
Chiropractor in Smyrna, GA. Individual provider (NPI-1).
NPI number1245397702
StatusActive
Last updated in NPPESJul 28, 2022
Details
- NPI
- 1245397702
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kenneth L McRae
- Credential
- DC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 3, 2007
- Certification date
- Jul 28, 2022
- Last updated
- Jul 28, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CHIROPRACTIC
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 008066 | GA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 008066 | GA |
Practice location
2325 Log Cabin Dr SeSuite 107
Smyrna, GA 30080-6798
Phone 770-432-1199 · Fax 770-432-1195
Mailing address
2325 Log Cabin Dr SeSuite 107
Smyrna, GA 30080-6798
Phone 678-977-3326 · Fax 770-432-1195
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