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General NPI Number Information
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NPI Number | 1285603431
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Entity Type | Individual
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Provider Name | KIM C MACKEY MD
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Gender | Male
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 22 ROULSTON RD
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City | WINDHAM
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State | NH
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Zip | 03087-1209
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Country | US
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Telephone | 608-575-4519
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 TUTTLE ST
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City | BARABOO
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State | WI
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Zip | 53913-3319
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Country | US
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Telephone | 608-355-3800
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Fax | 608-355-7001
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD61604924
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD61604924
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 43887
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License Number State | WI
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