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Organization

MACKEY VISION CENTER PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BENJAMIN L MACKEY M.D. (PRESIDENT)
(606) 528-1143
Entity
Organization

Contact information

Practice address
281 N. COMMONWEALTH AVE., CORBIN, KY 40702
(606) 528-1143
(606) 523-1145
Mailing address
PO BOX 880, CORBIN, KY 40702-0880

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
207W00000X
Ophthalmology Physician
Primary
37261
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64052327
KY
05
77007128
KY
Enumeration date
12/13/2007
Last updated
04/08/2009
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