Healthcare Provider Details

I. General information

NPI: 1700871027
Provider Name (Legal Business Name): DOUGLAS H MACKAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3928 WASHINGTON RD SUITE 230
MC MURRAY PA
15317-2537
US

IV. Provider business mailing address

3928 WASHINGTON RD SUITE 230
MC MURRAY PA
15317-2537
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-1866
  • Fax: 724-941-1647
Mailing address:
  • Phone: 724-941-1866
  • Fax: 724-941-1647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD 056095L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: