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NPI Code Detail

MEDICARE: DR. ANGELA KAY STAPLETON-MACKENZIE M.D.

MEDICARE: DR. ANGELA KAY STAPLETON-MACKENZIE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician136291CA
2207Q00000XFamily Medicine Physician113071MO
3207Q00000XFamily Medicine PhysicianMD60776458WA
4207QA0505XAdult Medicine PhysicianME161192FL
5207Q00000XFamily Medicine PhysicianME161192FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
227472051OTHERMOBCBS

General Provider Information

NPI Number : 1518969575
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA KAY STAPLETON-MACKENZIE M.D.
Provider Business Mailing Address
First Line : PO BOX 746638
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6638
Country : US
Telephone Number : 904-202-2092
Fax Number : 904-376-4075
Provider Business Practice Location Address
First Line : 400 COLONNADE DR STE 160
Second Line :
City : PONTE VEDRA
State : FL
Zip : 32081-6236
Country : US
Telephone Number : 904-824-1020
Fax Number : 904-390-7503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2005
Last Update Date : 06/09/2025

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Directions to “ DR. ANGELA KAY STAPLETON-MACKENZIE M.D.” Practice Location

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