Mackenzie, Gordon P.
Mackenzie, Gordon P. is an individual health care provider with primary practice located at 675 N Matthews Rd , Lake City SC 29560-7027. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Mackenzie, Gordon P. can be contacted via phone (843) 394-7419.Contact Information
Primary practice address
675 N Matthews Rd
Lake City SC 29560-7027
Phone: (843) 394-7419
Fax: (843) 661-4892
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X |
Profile Details
| NPI number | 1942328471 |
|---|---|
| LBN Legal business name | Mackenzie, Gordon P. |
| Credentials | Bachelor of Arts (BA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 26th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942328471 | NPPES |
| South Carolina | MEDICAID | 376241 |
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