Individual
DAVID PHILLIP MACKEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
845 S MADISON ST, TUPELO, MS 38801-4905
(662) 377-5930
(662) 377-5085
Mailing address
5482 HIGHWAY 15 N, ECRU, MS 38841-8471
(662) 488-8799
(662) 488-8729
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
R857999
MS
363LF0000X
Family Nurse Practitioner
Primary
R857999
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03824819
—
MS
Enumeration date
07/09/2012
Last updated
04/01/2020
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