Mack, Vicki Lynn
Mack, Vicki Lynn is an individual health care provider with primary practice located at 125 N Enola Dr Suite 101, Enola PA 17025-2500. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mack, Vicki Lynn can be contacted via phone (717) 732-7171.Contact Information
Primary practice address
125 N Enola Dr Suite 101
Enola PA 17025-2500
Phone: (717) 732-7171
Fax: (717) 732-8872
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD067040L | Pennsylvania |
Profile Details
| NPI number | 1730101254 |
|---|---|
| LBN Legal business name | Mack, Vicki Lynn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1730101254 | NPPES |
| Pennsylvania | MEDICAID | 0017468620001 |
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