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General NPI Number Information
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NPI Number | 1194763193
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Entity Type | Individual
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Provider Name | KEVIN P MACY DO
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 7790 DAYTON SPRINGFIELD RD STE B
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City | FAIRBORN
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State | OH
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Zip | 45324-1996
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Country | US
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Telephone | 937-340-6440
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Fax | 937-340-6441
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Provider Business Mailing Address
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Address Line | 3250 MIDDLE URBANA RD
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City | SPRINGFIELD
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State | OH
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Zip | 45502-9285
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Country | US
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Telephone | 937-399-7777
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Fax | 937-399-6794
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34008784
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License Number State | OH
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