Individual
MICHAEL ALEXANDER MACKINNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504-0649
(928) 729-8000
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA0635
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
RN116167
AZ
Other
Enumeration date
07/31/2009
Last updated
04/29/2026
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