Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. GLEN CARLISLE MACKENZIE, MD
Active Sole ProprietorMR. GLEN CARLISLE MACKENZIE, MD is a Gynecology healthcare provider located in MANCHESTER CENTER, Vermont. NPI 1306926704 is currently active in the NPPES registry. Verify at CMS.
Gynecology · MANCHESTER CENTER, VT
Registration Details
- NPI Number
- 1306926704
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 17, 2006 (19.835307385665 yrs)
- Last Updated
- Jun 17, 2022
- Licenses
-
0420009174 (VT)0420009174 (VT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1009 DEPOT STMANCHESTER CENTER, VT, 052559731Browse VT providers · Browse ZIP 05255
- Phone
- 8024428649
- Fax
- 8024428658
- Primary Specialty
-
Gynecology
207VG0400X
- Additional Specialty
- Gynecology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.