Healthcare Provider Details

I. General information

NPI: 1164876413
Provider Name (Legal Business Name): JAMES SCOTT MACKENZIE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2016
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 W UNION HILLS DR STE 1800
GLENDALE AZ
85308-1372
US

IV. Provider business mailing address

PO BOX 19406
BELFAST ME
04915-4089
US

V. Phone/Fax

Practice location:
  • Phone: 480-420-0749
  • Fax: 480-420-0732
Mailing address:
  • Phone: 469-803-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number79236
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberUMPS
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: