Active NPIIndividual providerSole proprietor

Mr. Glen C Mackenzie, MD

Obstetrics & Gynecology, Gynecology in Manchester Center, Vermont

NPI Number1306926704
Practice location
1009 Depot St, Manchester Center, VT 05255-9731
Fax
802-442-8658
Last updated
June 17, 2022

Glen Carlisle Mackenzie is an Obstetrics & Gynecology, Gynecology based in Manchester Center, VT. Glen Carlisle Mackenzie practices in Manchester Center, VT and has the professional credentials of MD. The NPI Number for Glen Carlisle Mackenzie is 1306926704 and holds a License No. 0420009174 (VT). The current practice location address for Glen Carlisle Mackenzie is 1009 Depot St, Manchester Center, VT 05255-9731 and can be reached out via phone at 802-442-8649 and via fax at 802-442-8658.

Provider Profile Details

NPI Number
1306926704
Provider Name
Glen Carlisle Mackenzie
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1009 Depot St, Manchester Center, VT 05255-9731
Phone Number
802-442-8649
Fax Number
802-442-8658
Primary Taxonomy
Obstetrics & Gynecology, Gynecology · 207VG0400X
Sole Proprietor
Yes
Provider Enumeration Date
October 17, 2006
Last Update Date
June 17, 2022
Certification Date
June 17, 2022
NPI Status
Active

Provider Business Practice Location Address Details

Address
1009 Depot St
Manchester Center, VT 05255-9731
State
Vermont
Zip
05255-9731
Phone Number
802-442-8649
Fax Number
802-442-8658
Manchester Center, VT 05255Get directions →

Provider Business Mailing Address Details

Address
1009 Depot St
Manchester Center, VT 05255-9731
City
Manchester Center
State
VT
Zip
05255-9731
Phone Number
802-442-8649
Fax Number
802-442-8658

License Information

License Number (1)
0420009174
License State (1)
VT
Taxonomy (1)
Obstetrics & Gynecology · 207V00000X
License Number (2)
0420009174
License State (2)
VT
Taxonomy (2)
Obstetrics & Gynecology, Gynecology · 207VG0400X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Mr. Glen C Mackenzie, MD?

The NPI number of Mr. Glen C Mackenzie, MD is 1306926704. It was assigned on October 17, 2006 and is currently active in the NPPES registry.

What is the specialty of Mr. Glen C Mackenzie, MD?

Mr. Glen C Mackenzie, MD is registered under the primary taxonomy Obstetrics & Gynecology, Gynecology (code 207VG0400X), licensed in VT under license number 0420009174.

Where does Mr. Glen C Mackenzie, MD practice?

The practice location is 1009 Depot St, Manchester Center, VT 05255-9731. The office can be reached at 802-442-8649 (phone) or 802-442-8658 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1306926704 directly on the NPPES registry website.

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