Gavin Christopher Mackie | Columbia, MO • PECOS Search

Gavin Christopher Mackie

Radiology

Allopathic & Osteopathic Physicians

One Hospital Drive, Columbia, MO 65212-0001

(573) 882-1026 (573) 882-2259

PECOS Enrollment

Based on the most recent information from CMS, provider Gavin Christopher Mackie does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1407802499
Provider Type
Individual
Full Name
Mackie, Gavin Christopher
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
5/25/2006
Last Updated
12/28/2007

Contact Information

Practice Location

One Hospital Drive, Columbia, MO 65212-0001

(573) 884-8876

Mailing Location

PO Box 7687, Columbia, MO 65205-7687

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License 2004014271 Missouri