Provider Demographics
NPI:1053007013
Name:ISBELL, MACKENZIE PAIGE (MD)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:PAIGE
Last Name:ISBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6411 GALETA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-3805
Mailing Address - Country:US
Mailing Address - Phone:719-761-1407
Mailing Address - Fax:
Practice Address - Street 1:22 S. GREEN ST.
Practice Address - Street 2:N5W70A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-3805
Practice Address - Country:US
Practice Address - Phone:410-328-6960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program