Organization
ROBERT A MACKIN, MD DBA NORTHERN ARIZONA SLEEP LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT A MACKIN M.D. (OWNER)
(928) 773-1748
Entity
Organization
Contact information
Practice address
77 W FOREST AVE STE 205, FLAGSTAFF, AZ 86001-1483
(928) 773-1748
(928) 773-9022
Mailing address
77 W FOREST AVE STE 205, FLAGSTAFF, AZ 86001-1483
(928) 773-1748
(928) 773-9022
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
17570
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
913807
—
AZ
01
—
AZ0257580
BLUE CROSS
AZ
Enumeration date
04/15/2008
Last updated
09/16/2008
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