Individual
DR. ROBERT A MACKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
823 NORTH BEAVER STREET, FLAGSTAFF, AZ 86001
(928) 773-1638
(928) 773-9022
Mailing address
823 NORTH BEAVER STREET, FLAGSTAFF, AZ 86001
(928) 773-1638
(928) 773-9022
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
17570
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277451
—
AZ
01
—
AZ0257580
BLUE CROSS
AZ
Enumeration date
10/24/2006
Last updated
08/17/2016
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