Provider Demographics
NPI:1851380810
Name:MACKAY, JOHN M JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:MACKAY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:5130 GATEWAY BLVD E # 51015
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-1608
Mailing Address - Country:US
Mailing Address - Phone:915-215-4480
Mailing Address - Fax:915-215-5386
Practice Address - Street 1:4815 ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2705
Practice Address - Country:US
Practice Address - Phone:915-521-7415
Practice Address - Fax:915-521-7920
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2023-11-08
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Provider Licenses
StateLicense IDTaxonomies
TXJ4898207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX106012102Medicaid
TXJ4898OtherSTATE LICENSE
TXJ4898OtherSTATE LICENSE
TX106012102Medicaid