Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD00019161 | WA |
NPI | 1063566529 |
---|---|
Provider Name | Alexander R Mackay |
First Address | Spokane, WA 99220-3868 |
Second Address | Spokane, WA 99204-2966 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 24/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1084920 | (05) | WA |
F52253 | (02) |