MEDICARE: DR. HEATHER A MCKENZIE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	L6110	TX
2	2083P0011X	Undersea and Hyperbaric Medicine (Preventive Medicine) Physician	L6110	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8BB450	OTHER		BCBS
3	6023560	OTHER	TX	CIGNA
4	7527630	OTHER	TX	AETNA
5	8K6279	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1811930431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEATHER A MCKENZIE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 5730
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-5700
Country	:	US
Telephone Number	:	888-402-7256
Fax Number	:	888-902-1099

Provider Business Practice Location Address
First Line	:	8811 VILLAGE DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-5415
Country	:	US
Telephone Number	:	210-297-2520
Fax Number	:	210-297-2539

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	06/12/2024

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Directions to “ DR. HEATHER A MCKENZIE M.D.” Practice Location

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