Provider Demographics
NPI:1285354381
Name:FLOWERS, MACKENZIE M (PA)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:M
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 HOSPITAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-1981
Mailing Address - Country:US
Mailing Address - Phone:513-732-0663
Mailing Address - Fax:513-732-0123
Practice Address - Street 1:2055 HOSPITAL DR STE 300
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-1981
Practice Address - Country:US
Practice Address - Phone:513-732-0663
Practice Address - Fax:513-732-1232
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.007752RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant