Mack, Timothy B
Mack, Timothy B is an individual health care provider with primary practice located at 255 W Lancaster Ave Ste 330 , Paoli PA 19301-1766. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mack, Timothy B can be contacted via phone (610) 786-3200.Contact Information
Primary practice address
255 W Lancaster Ave Ste 330
Paoli PA 19301-1766
Phone: (610) 786-3200
Fax: (610) 786-3208
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OS017355 | Pennsylvania |
Profile Details
| NPI number | 1306106836 |
|---|---|
| LBN Legal business name | Mack, Timothy B |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2012 |
| Last updated | Jul 21st, 2022 - about 2 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 | 1306106836 | NPPES |
| Pennsylvania | MEDICAID | 1030080050001 |
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