Healthcare Provider Details

I. General information

NPI: 1740639632
Provider Name (Legal Business Name): MACKENZIE EGAN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MACKENZIE ANNE BARBER

II. Dates (important events)

Enumeration Date: 06/10/2016
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12450 YORK ST
THORNTON CO
80241-2741
US

IV. Provider business mailing address

8614 WESTWOOD CENTER DR FL 9
VIENNA VA
22182-2442
US

V. Phone/Fax

Practice location:
  • Phone: 303-452-2020
  • Fax: 303-452-0934
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.0003426
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2982
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: