Individual
KIM C MACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 ROULSTON RD, WINDHAM, NH 03087-1209
(608) 575-4519
Mailing address
1700 TUTTLE ST, BARABOO, WI 53913-3319
(608) 355-3800
(608) 355-7001
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
43887
WI
207V00000X
Obstetrics & Gynecology Physician
MD61604924
WA
207V00000X
Obstetrics & Gynecology Physician
ME180291
FL
208M00000X
Hospitalist Physician
MD61604924
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285603431
—
WI
05
—
2298975
—
WA
Enumeration date
03/17/2006
Last updated
04/16/2026
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