Individual
DR. ANDREW IAN MACKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1715 MCCULLOUGH AVE FL 2, SAN ANTONIO, TX 78212-4046
(210) 558-0122
(210) 558-0115
Mailing address
1715 MCCULLOUGH AVE FL 2, SAN ANTONIO, TX 78212-4046
(210) 558-0122
(210) 558-0115
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
44788-020
WI
207RC0000X
Cardiovascular Disease Physician
KY43702
KY
207RC0000X
Cardiovascular Disease Physician
Primary
N1750
TX
207RI0011X
Interventional Cardiology Physician
KY43702
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TXB154710
WELLMED NETWORKS INC
—
Enumeration date
07/12/2006
Last updated
09/17/2021
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