Individual
JOHN NEWTON MACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIANS ASSITANT
Contact information
Practice address
558 NORWICH ROAD, PLAINFIELD, CT 06374
(860) 564-4054
(860) 564-0354
Mailing address
558 NORWICH ROAD, PLAINFIELD, CT 06374
(860) 564-4054
(860) 564-0354
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001429
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004224490
—
CT
01
—
290001429CT02
BC BS
CT
Enumeration date
11/27/2006
Last updated
05/27/2022
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