Provider Demographics
NPI:1477875714
Name:MCKENZIE, VINCENT (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:MCKENZIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5661 N PLACITA DE LA NOCHE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718
Mailing Address - Country:US
Mailing Address - Phone:520-299-2224
Mailing Address - Fax:
Practice Address - Street 1:5661 N PLACITA DE LA NOCHE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718
Practice Address - Country:US
Practice Address - Phone:520-299-2224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPB3096207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine