Healthcare Provider Details

I. General information

NPI: 1316967136
Provider Name (Legal Business Name): CRAIG D MACKEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BAUGHMAN AVE. SUITE B
DANVILLE KY
40422
US

IV. Provider business mailing address

PO BOX 356
DANVILLE KY
40423-0356
US

V. Phone/Fax

Practice location:
  • Phone: 859-238-9300
  • Fax: 859-238-9977
Mailing address:
  • Phone: 859-238-9300
  • Fax: 859-238-9977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4129
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number4129
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: