Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 36.003579 | OH |
NPI | 1013158658 |
---|---|
Provider Name | Dr. Renee Lenore Mackey |
First Address | Kent, OH 44240-4112 |
Second Address | Fairlawn, OH 44333-3614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2009 |
Last Update Date | 20/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000718318 | ANTHEM (01) | OH |
0052496 | (05) | OH |
1013158658 | MEDICAL MUTUAL (01) | OH |
2286732 | COVENTRY HEALTHCARE/FIRST HEALTH NETWORK (01) | OH |
30-0506709 | CARESOURCE (01) | OH |
30-0506709 | HOMETOWN (01) | OH |
30-0506709 | UNITED HEALTHCARE (01) | OH |
8848863 | CIGNA (01) | OH |
9047186 | SUMMA (01) | OH |
9486718 | AETNA (01) | OH |
P00980802 | RR MEDICARE (01) | OH |