MR. GLEN CARLISLE MACKENZIE


Address: 160 Benmont Avenue, Suite 22, Bennington, VT 05201
Phone: 8024428649

MR. GLEN CARLISLE MACKENZIE (NPI# 1306926704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306926704
Entity Type Individual
Full Name MR. GLEN CARLISLE MACKENZIE
Credential MD
Practice Address 160 Benmont Avenue
Suite 22
Bennington
VT 05201
Practice Telephone 8024428649
Practice Fax Number 8024428658
Mailing Telephone 8024428649
Mailing Fax Number 8024428658
Enumeration Date 2006-10-17
Last Update Date 2016-04-20
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207V00000X Obstetrics & Gynecology 0420009174 VT Allopathic & Osteopathic Physicians
Y 207VG0400X Obstetrics & Gynecology
Specialization: Gynecology
0420009174 VT Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
VT OVN1210 05

Office Location

Street Address 160 BENMONT AVENUE
SUITE 22
City BENNINGTON
State VT
Zip Code 05201

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NPI Name Taxonomy Address Enumeration
1386704948 William Elliott Guild Dentist 160 Benmont Avenue, Suite 21, Bennington, VT 05201 2006-12-12

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NPI Name Taxonomy Address Enumeration
1154720951 Justin Carl Wilkinson Specialist/Technologist 320 Elm St, Bennington, VT 05201 2014-08-18
1134533235 Patrick Deedy Specialist/Technologist 5 Appletree Ln, Bennington, VT 05201 2014-06-17
1083974299 Khola Qamar Internal Medicine 140 Hospital Dr Ste 307, Bennington, VT 05201 2012-05-22
1295039808 Bernadette R. Potratz Massage Therapist 160 Benmont Ave., Suite 23, Bennington, VT 05201 2010-12-23
1780870642 Aaron York Psychiatry & Neurology 186 North Street, Bennington Va Clinic, Bennington, VT 05201 2007-09-24
1053434100 Sunrise Family Resource Center Social Worker 244 Union Street, Bennington, VT 05201 2007-04-06
1316022817 New England Consulting Inc Chiropractor 125 Elm Street, Bennington, VT 05201 2006-10-25
1982796496 Maureen Matthews Mcclintock Social Worker 655 Main St., Bennington, VT 05201 2006-09-29
1447270525 Robert J Miller Dentist 129 Elm Street, Bennington, VT 05201 2006-07-20
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Taxonomy Information

Taxonomy Code 207VG0400X
Grouping Allopathic & Osteopathic Physicians
Classification Obstetrics & Gynecology
Specialization Gynecology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1467806067 Glen Mackenzie Md PC Obstetrics & Gynecology 160 Benmont Ave, Suite 22, Bennington, VT 05201-1873 2016-04-20
1174516397 Sarah Perkins Dahl Obstetrics & Gynecology 345 Elm St, Bennington, VT 05201-2265 2005-08-23

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1992759823 Vermont Urogynecology Associates, PC Obstetrics & Gynecology 71 Knight Ln, Suite 10, Williston, VT 05495-4432 2006-05-22
1467448787 Gamal H Eltabbakh Obstetrics & Gynecology 1060 Hinesburg Rd, Suite 301, South Burlington, VT 05403-7612 2005-09-22
1205127354 Stephen J Woodruff Md Pllc Obstetrics & Gynecology 22 Eastview Lane, Barre, VT 05641-5317 2011-04-25
1174830251 Vermont Gynecology, PC Obstetrics & Gynecology 1775 Williston Rd Ste 110, South Burlington, VT 05403-6491 2010-09-09
1235463027 Jane G Conolly Obstetrics & Gynecology 1775 Williston Rd, Suite 110, South Burlington, VT 05403-6491 2009-09-25
1265622070 Noelle C Thabault Md LLC Obstetrics & Gynecology 368 Dorset St, Suite 2b, South Burlington, VT 05403-6236 2007-07-27
1891740775 Diane Charland Obstetrics & Gynecology 71 Knight Ln, Suite 10, Williston, VT 05495-4432 2006-05-22
1932154895 Anne Viselli Obstetrics & Gynecology 71 Knight Ln, Suite 10, Williston, VT 05495-4432 2006-05-22

Competitor

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City BENNINGTON
Zip Code 05201

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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