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General NPI Number Information
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NPI Number | 1710214820
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Entity Type | Individual
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Provider Name | ALEXANDER C MACKINNON JR. M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/10/2009
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 619 19TH ST S
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City | BIRMINGHAM
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State | AL
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Zip | 35249-3522
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Country | US
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Telephone | 205-934-4011
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Fax | 205-297-9411
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Provider Business Mailing Address
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Address Line | PO BOX 55310
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City | BIRMINGHAM
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State | AL
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Zip | 35255-5310
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Country | US
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Telephone | 205-731-9701
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Fax | 205-297-9411
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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 | 207ZP0007X
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Taxonomy Name | Molecular Genetic Pathology (Pathology) Physician
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License Number | 54826
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207ZP0007X
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Taxonomy Name | Molecular Genetic Pathology (Pathology) Physician
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License Number | 036.118124
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 54826
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 036.118124
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 38623
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License Number State | AL
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