Individual
BRIAN C MACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5253 DIJON DR STE A, BATON ROUGE, LA 70808-4312
(225) 768-1611
(225) 768-1615
Mailing address
5253 DIJON DR STE A, BATON ROUGE, LA 70808-4312
(225) 768-1611
(225) 768-1615
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
RN 081239/AP03511
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942405
—
LA
Enumeration date
10/11/2006
Last updated
07/08/2007
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