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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
VT | OVN1210 | 05 |
Street Address |
160 BENMONT AVENUE SUITE 22 |
City | BENNINGTON |
State | VT |
Zip Code | 05201 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386704948 | William Elliott Guild | Dentist | 160 Benmont Avenue, Suite 21, Bennington, VT 05201 | 2006-12-12 |
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 |
1952354680 | Nels Andreas Kloster | Psychiatry & Neurology | 601 Main St Ste 104, Bennington, VT 05201 | 2006-05-17 |
Find all providers in zip 05201 |
Taxonomy Code | 207VG0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Obstetrics & Gynecology |
Specialization | Gynecology |
Definition to come... |
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 |
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 |
City | BENNINGTON |
Zip Code | 05201 |
Please comment or provide details below to improve the information on MR. GLEN CARLISLE MACKENZIE.
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.