Mack, Thomas Val

Mack, Thomas Val is an individual health care provider with primary practice located at 4061 Old Peshtigo Rd , Marinette WI 54143-3887. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Mack, Thomas Val can be contacted via phone (715) 732-8090.

Contact Information

Primary practice address
4061 Old Peshtigo Rd Marinette WI 54143-3887
Phone: (715) 732-8090
Fax: (715) 732-8015
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 21285-20 Wisconsin

Profile Details

NPI number 1417987470
LBN Legal business name Mack, Thomas Val
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2006
Last updated Oct 17th, 2018 - about 7 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 1417987470 NPPES
Other P01529036 MEDICARE RAILROAD
MEDICAID 30126200 MEDICARE RAILROAD

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