Most Relevant Information
Provider Data
| NPI Number: | 1003317421 |
| Provider Name: | KELLY ANN MACKESSY DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/21/2018 |
| Last Updated: | 08/29/2024 |
Provider Practice Location
1 MEDICAL VILLAGE DR
EDGEWOOD
KY
410173403
Practice Location Phone/Fax
| Phone: | 8595785880 |
| Fax: | 8595785881 |
Provider Mailing Location
PO BOX 636324
CINCINNATI
OH
452636324
Provider Mailing Phone/Fax
| Phone: | 8593012273 |
| Fax: | 8593016182 |