Zachary H McKenty, Physician Assistant
Physician Assistant in Carbondale, IL. Individual provider (NPI-1).
NPI number1407190812
StatusActive
Last updated in NPPESJun 10, 2020
Details
- NPI
- 1407190812
- Entity type
- Individual (NPI-1)
- Name
- Zachary H McKenty
- Credential
- Physician Assistant
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 26, 2012
- Certification date
- Jun 10, 2020
- Last updated
- Jun 10, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
| 1710I1003X | Military Health Care Provider, Independent Duty Medical Technicians | – | – |
Practice location
300 W Oak StCarbondale, IL 62901-1400
Phone 618-453-8850
Mailing address
3736 Parador DrNaperville, IL 60564-3109
Phone 630-918-0603
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All 68 Physician Assistant providers in Carbondale · All 1,335 providers in Carbondale
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