Provider Demographics
NPI:1487776449
Name:MCKENZIE, RICHARD G (DO)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:G
Last Name:MCKENZIE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 ST JOHNSBURY ROAD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561
Mailing Address - Country:US
Mailing Address - Phone:603-444-7070
Mailing Address - Fax:603-575-6288
Practice Address - Street 1:580 ST JOHNSBURY ROAD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561
Practice Address - Country:US
Practice Address - Phone:603-444-7070
Practice Address - Fax:603-575-6288
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH14296207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine