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GLEN MACKENZIE MD PC NPI 1467806067


NPI Information

NPI: 1467806067
Provider Name: GLEN MACKENZIE MD PC
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

Address:
1009 DEPOT ST
MANCHESTER CENTER, VT
ZIP 05255
Phone: (802) 442-8649
Get Directions

GLEN MACKENZIE MD PC is a gynecology obstetrics gynecology in Manchester Center, VT. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee GLEN MACKENZIE MD PC NPI is 1467806067. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1009 DEPOT ST
MANCHESTER CENTER, VT
ZIP 05255-731
Phone: (802) 442-8649
Fax: (802) 442-8658

The provider's authorized official is Glen Carlisle Mackenzie .
The authorized official title is President and has the following contact phone number (802) 442-8649.

The enumeration date for this NPI number is 4/20/2016 and was last updated on 6/17/2022.


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
1207VG0400XObstetrics & GynecologyGynecology420009174VERMONTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1OVN1210MEDICAIDVERMONT

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

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