Organization
MACKEY FAMILY PRACTICE, PA
Active
Parent organization
MACKEY FAMILY PRACTICE, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
MACKEY FAMILY PRACTICE, PA
Authorized official
DR. KEITH D SHEALY M. D. (PRESIDENT)
(803) 285-7414
Entity
Organization
Contact information
Practice address
8351 CHARLOTTE HWY, SUITE 200, INDIAN LAND, SC 29707-6552
(803) 396-5368
(803) 396-5350
Mailing address
8351 CHARLOTTE HWY, SUITE 200, INDIAN LAND, SC 29707-6552
(803) 396-5368
(803) 396-5350
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHC211
—
SC
Enumeration date
10/04/2011
Last updated
10/10/2023
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