DR. KEITH ANDREW MACKENZIE (NPI# 1861498297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861498297 |
| Entity Type | Individual |
| Full Name | DR. KEITH ANDREW MACKENZIE |
| Credential | D.O. |
| Practice Address |
3190 Clearwater Dr Prescott AZ 86305-7131 |
| Mailing Address |
Po Box 11208 Prescott AZ 86304-1208 |
| Practice Telephone | 9285411312 |
| Practice Fax Number | 9285410002 |
| Mailing Telephone | 9285411312 |
| Mailing Fax Number | 9285410002 |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2012-04-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
3225 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 390766 | 05 |
| Street Address |
3190 CLEARWATER DR |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86305-7131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396971958 | Keith A Mackenzie Do PC | Dermatology | 3190 Clearwater Dr, Prescott, AZ 86305-7131 | 2009-06-09 |
| 1285817122 | Kimberly Carlson Stover | Registered Nurse | 3190 Clearwater Dr, Prescott, AZ 86305-7131 | 2007-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972005395 | Granite View Adult Care Home LLC | Assisted Living Facility | 7105 Williamson Valley Road, Prescott, AZ 86305 | 2018-03-01 |
| 1215468095 | Valerie Williams | Occupational Therapist | 926 S. Hinman Dr., Prescott, AZ 86305 | 2017-03-23 |
| 1174073837 | Caspian Gleam Medical Center LLC | Clinic/Center | 3130 Stillwater Drive, Suite B, Prescott, AZ 86305 | 2016-10-06 |
| 1114388634 | Marla Beth Perkins | Speech-Language Pathologist | 3160 Stillwater Dr., Prescott, AZ 86305 | 2016-03-10 |
| 1790159853 | Michele A. Bibeau, D.d.s. | Dentist | 1058 Fair Street, Suite A, Prescott, AZ 86305 | 2015-11-30 |
| 1609264837 | Integrative Pain Centres of Prescott | Pain Medicine | 3769 Crossings Drive, Suite B, Integrative Pain Centres of Prescott, Prescott, AZ 86305 | 2014-12-22 |
| 1649697251 | Sharon Marilyn Jackson | Counselor | 3636 Crossings Drive, Prescott, AZ 86305 | 2014-03-20 |
| 1215351259 | Stefanie Maneval | Registered Nurse | 900 Iron Springs Rd, Prescott, AZ 86305 | 2014-02-11 |
| 1508207523 | Recovery In The Pines, LLC | Community/Behavioral Health | 919 12th Place #13, Prescott, AZ 86305 | 2013-07-08 |
| 1871857359 | Neal Herbert Segovia Cabaluna | Internal Medicine | 3773 Crossings Dr Ste C, Prescott, AZ 86305 | 2012-06-28 |
| Find all providers in zip 86305 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396971958 | Keith A Mackenzie Do PC | Dermatology | 3190 Clearwater Dr, Prescott, AZ 86305-7131 | 2009-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871051383 | Skin Deep Aesthetics, LLC | Dermatology | 1714 W Guadalupe Rd Ste 201, Gilbert, AZ 85233-2943 | 2019-03-05 |
| 1982819397 | Tamra Whiteley-myers Md PC | Dermatology | 5190 E Farness Dr Ste 110, Tucson, AZ 85712-2142 | 2007-05-11 |
| 1871653840 | Cynthia Jean Modny | Dermatology | 2402 E San Miguel Ave, Phoenix, AZ 85016-2815 | 2006-12-11 |
| 1518928878 | Mark A Meyers | Dermatology | 715 S Beeline Hwy, Ste A, Payson, AZ 85541-5344 | 2006-03-28 |
| 1235128851 | Andrew S. Tedesco | Dermatology | 6648 E Carondelet Dr, Tucson, AZ 85710-2119 | 2005-10-17 |
| 1083066450 | Arizona Skin and Laser Therapy Institue, Ltd | Dermatology | 16620 N 40th St, Suite C-3, Phoenix, AZ 85032-3348 | 2016-07-08 |
| 1548634348 | La Peau Dermatology LLC | Dermatology | 5424 E Southern Ave, Suite 103, Mesa, AZ 85206-3621 | 2015-11-17 |
| 1972861326 | Ryan Mark Proctor | Dermatology | 3015 Hway 95, Suite 110, Bullhead City, AZ 86442-4334 | 2012-04-23 |
| 1427340389 | Brenda Latowsky M.d. P.l.c. | Dermatology | 12251 N 32nd St, Phoenix, AZ 85032-7189 | 2011-05-11 |
| 1003112327 | Northern Arizona Dermatology Center, PC | Dermatology | 501 N Navajo, Page, AZ 86040 | 2011-02-03 |
| Find all providers with the same taxonomy | ||||
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| 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.