Mckay, Jack Edward
Mckay, Jack Edward is an individual health care provider with primary practice located at 1034 Mar Walt Dr Unit 100 , Fort Walton Beach FL 32547-6637. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Mckay, Jack Edward can be contacted via phone (850) 863-2153.Contact Information
Primary practice address
1034 Mar Walt Dr Unit 100
Fort Walton Beach FL 32547-6637
Phone: (850) 863-2153
Fax: (850) 863-8085
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | ME139390 | Florida |
Profile Details
| NPI number | 1932527942 |
|---|---|
| LBN Legal business name | Mckay, Jack Edward |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 7th, 2014 |
| Last updated | Mar 24th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932527942 | NPPES |
| Florida | Other | 14417668 | CAQH |
| Florida | Other | 53WFA | CAQH |
| Florida | MEDICAID | 801769 | CAQH |
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