Individual
KEITH MACKAY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
55 FOGG RD, SOUTH WEYMOUTH, MA 02190-2455
(781) 792-4121
Mailing address
55 FOGG RD, SOUTH WEYMOUTH, MA 02190-2432
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
024838
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/26/2019
Last updated
01/18/2023
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