Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD041954L | PA |
NPI | 1184680621 |
---|---|
Provider Name | Donald R Mackay |
First Address | Hershey, PA 17033-0858 |
Second Address | Hershey, PA 17033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 13/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12657800008 | (05) | PA |
F13127 | (02) |