Individual
PALMER J MACKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11725 ILLINOIS ST STE 250, CARMEL, IN 46032-3015
(317) 688-5300
(317) 688-5313
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01044359A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000086733
ANTHEM
IN
05
—
200067280
—
IN
Enumeration date
05/02/2006
Last updated
02/15/2023
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