Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Timothy Wayne Mackey Jr., IDC

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1366162059

Mr. Timothy Wayne Mackey Jr., IDC is a Student in an Organized Health Care Education/Training Program in FPO, Armed Forces Pacific. Works from 2 locations. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2

Practice location Address may be wrong

The ZIP code does not match the city and state on this record. Call before visiting.

Uss Abraham Lincoln Cvn 72
FPO, AP 96649
Phone: (912) 275-4040

Additional practice locations (1)

  • 34101 Farenholt Ave Bldg 14, San Diego, CA 92134-7000 — (619) 532-5110

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X · Licence 1366162059
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1366162059
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorNo
NPI enumeratedSeptember 1, 2022
Last updated in NPPESMarch 6, 2023
Certification dateMarch 2, 2023

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