Healthcare Provider Details

I. General information

NPI: 1366603045
Provider Name (Legal Business Name): MACKENZIE LOUGHLAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 E BARNETT RD
MEDFORD OR
97504-8332
US

IV. Provider business mailing address

2825 E BARNETT RD MSS
MEDFORD OR
97504-8332
US

V. Phone/Fax

Practice location:
  • Phone: 541-789-4233
  • Fax: 541-789-5936
Mailing address:
  • Phone: 541-789-4281
  • Fax: 541-789-4806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD160373
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD160373
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: