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Individual

GLENN MACKAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5701 STATE AVE STE 100, KANSAS CITY, KS 66102-1281
(913) 287-7800
(913) 287-1112
Mailing address
5701 STATE AVE STE 100, KANSAS CITY, KS 66102-1281
(913) 287-7800
(913) 287-1112

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
0427706
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100391820B
KS
05
100391820C
KS
Enumeration date
08/22/2006
Last updated
02/08/2012
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