Provider Demographics
NPI:1285652990
Name:MACKAY, RENE BENJAMIN (MD)
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:BENJAMIN
Last Name:MACKAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1360 CADUCEUS WAY BLDG 400-104
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677
Mailing Address - Country:US
Mailing Address - Phone:706-850-8135
Mailing Address - Fax:706-548-9101
Practice Address - Street 1:650 OGLETHORPE AVE
Practice Address - Street 2:SUITE #4
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2216
Practice Address - Country:US
Practice Address - Phone:706-850-8135
Practice Address - Fax:706-548-9101
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2019-05-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA051680207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology