Individual
DR. SUSAN E MACKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, DIV SURG PLASTICS, STE 6G, SAINT LOUIS, MO 63110-1032
(314) 362-7388
(833) 301-0853
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-7388
(833) 301-0853
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
102027
MO
2086S0105X
Surgery of the Hand (Surgery) Physician
102027
MO
2086S0122X
Plastic and Reconstructive Surgery Physician
102027
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203098306
—
MO
Enumeration date
07/14/2006
Last updated
04/17/2025
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