Provider Demographics
NPI:1194890491
Name:MCKENZIE, HARRY JAMES (MD)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:JAMES
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:PO BOX 148
Mailing Address - Street 2:237 HIGH STREET
Mailing Address - City:SALISBURY
Mailing Address - State:PA
Mailing Address - Zip Code:15558-0148
Mailing Address - Country:US
Mailing Address - Phone:814-662-6065
Mailing Address - Fax:
Practice Address - Street 1:237 HIGH ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:PA
Practice Address - Zip Code:15558-2203
Practice Address - Country:US
Practice Address - Phone:814-662-6065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054604L208G00000X
GA043707208G00000X, 208G00000X
KS0428567208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS336471OtherFIRST GUARD HEALTH PLAN
KS101786Medicare ID - Type Unspecified
H00675Medicare UPIN
KS12363OtherPREFERRED HEALTH
KS101786OtherBLUE CROSS BLUE SHIELD