Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD26615 | TN |
N | 207XS0117X | Orthopaedic Spine Surgeon | MD26615 | TN |
NPI | 1245222397 |
---|---|
Provider Name | Dr. Edward Scudder Mackey |
First Address | Nashville, TN 37204-3708 |
Second Address | Nashville, TN 37205-2013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 05/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E57554 | (02) | TN |