Provider Demographics
NPI:1093274011
Name:BARTSCH, MAKENZIE VOLKER (MD)
Entity Type:Individual
Prefix:
First Name:MAKENZIE
Middle Name:VOLKER
Last Name:BARTSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50770
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82605-0770
Mailing Address - Country:US
Mailing Address - Phone:307-333-6910
Mailing Address - Fax:307-333-6912
Practice Address - Street 1:2510 E 15TH ST STE 12
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4111
Practice Address - Country:US
Practice Address - Phone:307-333-6910
Practice Address - Fax:307-333-6912
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY15672A207P00000X
PAMD478171208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine