Dwayne Mackey

NPI 1427250430 · on the registry since 2007

Practice

Address: 518 N Hampton Ave
Republic R-Iii
Republic, MO 65738
Phone: (417) 732-3605
Fax: (417) 732-3609
Organisation at this address: Republic R-Iii
Advocates For A Healthy Community, Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

Registry record

Primary taxonomy: 225X00000X
225X00000X
Licence states on file: MO
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2009-02-23

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri