Mack, Dorothy M

Mack, Dorothy M is an individual health care provider with primary practice located at 655 7Th St , Robins Afb GA 31098-2227. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mack, Dorothy M can be contacted via phone (478) 327-7805.

Contact Information

Primary practice address
655 7Th St Robins Afb GA 31098-2227
Phone: (478) 327-7805
Fax: (478) 327-7816
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 003043 Georgia

Profile Details

NPI number 1346250099
LBN Legal business name Mack, Dorothy M
Credentials MPH, PA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2006
Last updated Mar 31st, 2022 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346250099 NPPES
Georgia MEDICAID 505983680C

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