Provider / Organization | NPI | Date Certified |
---|---|---|
DILLON JAMES MACKY | 1306420021 | 2021-05-09 |
Dillon James Macky is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1306420021. Registration indicates Dillon James Macky is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
Entity Type | Individual |
Provider Name | Dillon James Macky MD |
Practice Office Address | 300 W HOSPITAL RD FORT GORDON, GA US |
Practice Office Telephone | 4072429173 |
Mailing Address | 520 BRIGADIER LNDG GROVETOWN, GA 308133360 US |
Business Telephone | 4072429173 |
Code | Practice | License No State |
---|---|---|
390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | 93966
GA |