Individual
LEA MARLYS MACKINNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 ERWIN ROAD, DURHAM, NC 27710-3052
(919) 684-2711
Mailing address
PO BOX 63362, CHARLOTTE, NC 28263-3362
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2020-00318
NC
2085R0202X
Diagnostic Radiology Physician
R75042
AZ
Other
Enumeration date
05/26/2015
Last updated
07/16/2025
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