Provider Demographics
NPI:1063492262
Name:MACKEY, ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:MACKEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:30 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2052
Mailing Address - Country:US
Mailing Address - Phone:413-582-2792
Mailing Address - Fax:413-582-4675
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2052
Practice Address - Country:US
Practice Address - Phone:413-582-2792
Practice Address - Fax:413-582-4675
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2012-04-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA51058207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA04-2161484OtherNORTH AMERICAN PREFERRED
MAJ02259OtherBCBS MA
MA04-2161484OtherCONSOLIDATED
MA04-2161484OtherPRIVATE HEALTHCARE SYSTEM
MA04-2161484OtherPIONEER HEALTH NETWORK
MA702623OtherCONNECTICARE
MA000000007896OtherBMC
MA04-2161484OtherUNICARE/GIC
MA04-2161484OtherGREAT-WEST
MA14069OtherHEALTH NEW ENGLAND
MA2274527OtherAETNA
MA102566OtherCIGNA
MA04-2161484OtherNORTHEAST HEALTH DIRECT
MA04-2161484OtherNORTHEAST HEALTHCARE ALLI
MA438597OtherHARVARD PILGRIM
MA768151OtherTUFTS
MA04-2161484OtherPLAN VISTA
MA04-2161484OtherPIONEER HEALTH NETWORK