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Individual

DR. LORA E MACKIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
43480 YUKON DR STE 100, ASHBURN, VA 20147-6988
(571) 252-6000
(571) 252-6011
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101042024
VA
207Q00000X
Family Medicine Physician
D0071901
MD
207Q00000X
Family Medicine Physician
MD039753
DC

Other

Enumeration date
11/14/2006
Last updated
11/02/2011
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