Individual
PAUL EDWARD MACKELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
588 US HIGHWAY 287, SUITE 204, LAFAYETTE, CO 80026-2604
(303) 666-4606
(303) 666-4610
Mailing address
4269 CARTER TRL, BOULDER, CO 80301-3805
(303) 666-4606
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25320
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01253202
—
CO
01
—
1639358518
CORPORATION NPI
CO
Enumeration date
01/27/2007
Last updated
12/16/2010
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