Individual
DR. LINA MACKELAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
615 S PRESTON ST, LOUISVILLE, KY 40202-1715
(502) 852-5757
(502) 589-5093
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 852-5757
(502) 852-7643
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT183311
PA
207RN0300X
Nephrology Physician
Primary
43697
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100134410
—
KY
Enumeration date
09/10/2008
Last updated
08/29/2012
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