Provider Demographics
NPI:1598942849
Name:DR. MACKEY'S FAMILY CHIROPRACTIC, PSC
Entity Type:Organization
Organization Name:DR. MACKEY'S FAMILY CHIROPRACTIC, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-238-9300
Mailing Address - Street 1:PO BOX 356
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40423-0356
Mailing Address - Country:US
Mailing Address - Phone:859-238-9300
Mailing Address - Fax:859-238-9977
Practice Address - Street 1:100 BAUGHMAN AVE.
Practice Address - Street 2:SUITE B
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422
Practice Address - Country:US
Practice Address - Phone:859-238-9300
Practice Address - Fax:859-238-9977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4129111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYU48410Medicare UPIN
KY9918Medicare PIN