Individual
DR. MACKENZIE LEE GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
MACKENZIE GOODWIN MD DBA WASATCH SURGICAL LLC, 520 MEDICAL DR STE 300, BOUNTIFUL, UT 84010
(228) 273-9021
Mailing address
1893 E MILLBROOK RD, SALT LAKE CITY, UT 84106-3827
(228) 273-9021
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
11768709-1205
UT
2086S0102X
Surgical Critical Care Physician
Primary
11768709-1205
UT
2086X0206X
Surgical Oncology Physician
11768709-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11768709-1205
LICENSE
UT
Enumeration date
05/08/2012
Last updated
07/18/2025
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