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Individual

ALLAN ALEXANDER MACKAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 N CURRY PIKE, A1, BLOOMINGTON, IN 47404-2593
(812) 339-5424
(812) 339-5413
Mailing address
100 N CURRY PIKE, BLOOMINGTON, IN 47404-2593
(812) 339-5424
(812) 339-5413

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01062200A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000537577
BLUE CROSS/BLUE SHIELD
IN
05
200830920A
IN
Enumeration date
08/02/2006
Last updated
03/29/2016
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