Mackenzie, Keith Andrew

Mackenzie, Keith Andrew is an individual health care provider with primary practice located at 3190 Clearwater Dr , Prescott AZ 86305-7131. He recently has only one registered license in Allopathic & Osteopathic Physicians / Procedural Dermatology, which is considered as his primary health care specialty. Mackenzie, Keith Andrew can be contacted via phone (928) 541-1312.

Contact Information

Primary practice address
3190 Clearwater Dr Prescott AZ 86305-7131
Phone: (928) 541-1312
Fax: (928) 541-0002
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 3225 Arizona

Profile Details

NPI number 1861498297
LBN Legal business name Mackenzie, Keith Andrew
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Apr 25th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861498297 NPPES
Arizona MEDICAID 390766

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