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Individual

DR. JOSEPH MICHAEL MACKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1011 WEST SECOND STREET, BLOOMINGTON, IN 47403-2216
(812) 334-1213
(812) 333-5039
Mailing address
1011 WEST SECOND STREET, BLOOMINGTON, IN 47403-2216
(812) 334-1213
(812) 333-5039

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
TRN11512
FL
207W00000X
Ophthalmology Physician
Primary
01069717A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201025280
IN
Enumeration date
06/29/2007
Last updated
03/21/2012
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