Healthcare Provider Details

I. General information

NPI: 1053007013
Provider Name (Legal Business Name): MACKENZIE PAIGE ISBELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S. GREEN ST. N5W70A
BALTIMORE MD
21201-3805
US

IV. Provider business mailing address

6411 GALETA DR
COLORADO SPRINGS CO
80923-3805
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-6960
  • Fax:
Mailing address:
  • Phone: 719-761-1407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0077407
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: