Organization
ALLAN MACKAY MD PC
Active
Organization
ALLAN MACKAY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLAN ALEXANDER MACKAY M.D. (OWNER)
(812) 339-5424
Entity
Organization
Contact information
Practice address
100 N CURRY PIKE, SUITE A1, BLOOMINGTON, IN 47404
(812) 339-5424
(812) 339-5413
Mailing address
PO BOX 1350, BLOOMINGTON, IN 47402-1350
(812) 339-5424
(812) 339-5413
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
01062200A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000537577
BLUE CROSS/BLUE SHIELD
IN
05
—
200830920A
—
IN
Enumeration date
09/10/2007
Last updated
02/10/2015
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