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Dr. Clark R Mckenzie, MD
Interventional Cardiology Physician in Saint Louis, Missouri
NPI 1073506051

Clark R Mckenzie is a Interventional Cardiology Physician based in Saint Louis, MO and is specialized in Interventional Cardiology. Clark R Mckenzie practices in Saint Louis, MO and has the professional credentials of MD. The NPI Number for Clark R Mckenzie is 1073506051 and holds a License No. R4P62 (Missouri).

The current practice location address for Clark R Mckenzie is 450 N New Ballas Rd, Saint Louis, MO and can be reached out via phone at 314-991-6969 and via fax at 314-997-6969.

Location: 450 N New Ballas Rd, Saint Louis, MO, 63195-2632
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Provider Profile Details
NPI Number
1073506051
Provider Name
Clark R Mckenzie
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
450 N New Ballas Rd, Saint Louis, MO, 63195-2632
Phone Number
314-991-6969
Fax Number
314-997-6969
Provider Enumeration Date
08/25/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004013185 01 MO MEDICARE PROV ID AREA 99
1124011010 01 MO HHC CATH GROUP NPI
1881863009 01 MO FARM GROUP NPI
P00275849 01 MO RR CCL GROUP
006012762 01 MEDICARE PROVIDER ID
110171721 01 MO RR MEDICARE NUMBER
000047049 01 MO MCARE CCL GROUP NUMBER
CI7050 01 MO RR GROUP 99
MA1080 01 MO CCL GROUP NUMBER
1801889795 01 MO STL GROUP NPI
MA1080001 01 MO CCL INDIVDUAL PROV NUMBER
CD6536 01 MO RR GROUP 01
institution
Provider Business Practice Location Address Details
Address
450 N New Ballas Rd
City
State
Zip
63195-2632
Phone Number
314-991-6969
Fax Number
314-997-6969
person
Provider Business Mailing Address Details
Address
450 N New Ballas Rd
City
State
Zip
63195-2632
Phone Number
314-991-6969
Fax Number
314-997-6969
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Cardiovascular Disease
Taxonomy
License No.
R4P62 (Missouri)
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Interventional Cardiology
Taxonomy
License No.
R4P62 (Missouri)
Definition
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
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