Provider Demographics
NPI:1659980605
Name:MCKAY FAMILY PRACTICE PLLC
Entity Type:Organization
Organization Name:MCKAY FAMILY PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:801-210-2445
Mailing Address - Street 1:7478 S CAMPUS VIEW DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-1968
Mailing Address - Country:US
Mailing Address - Phone:012-102-4458
Mailing Address - Fax:385-200-8440
Practice Address - Street 1:7478 S CAMPUS VIEW DR STE 100
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-1968
Practice Address - Country:US
Practice Address - Phone:801-210-2445
Practice Address - Fax:385-200-8440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty