Healthcare Provider Details

I. General information

NPI: 1699087809
Provider Name (Legal Business Name): MORGAN JAMES MACKEY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2010
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9327 N 3RD ST STE 206
PHOENIX AZ
85020-2473
US

IV. Provider business mailing address

7300 RANCH ROAD 2222, BUILDING 1, STE 200
AUSTIN TX
78730
US

V. Phone/Fax

Practice location:
  • Phone: 602-944-4626
  • Fax: 602-396-5800
Mailing address:
  • Phone: 512-628-0465
  • Fax: 512-628-0468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number007055
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: