Mcconnell Mack, Amanda Nichole

Mcconnell Mack, Amanda Nichole is an individual health care provider with primary practice located at 90 Jackson Pike , Gallipolis OH 45631-1560. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Mcconnell Mack, Amanda Nichole can be contacted via phone (740) 446-5763.

Contact Information

Primary practice address
90 Jackson Pike Gallipolis OH 45631-1560
Phone: (740) 446-5763
Fax: (740) 446-5573
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sleep Medicine 2084S0012X 34.010575 Ohio
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 34.010575 Ohio

Profile Details

NPI number 1740424076
LBN Legal business name Mcconnell Mack, Amanda Nichole
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 30th, 2009
Last updated Jan 11th, 2021 - 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 1740424076 NPPES
West Virginia MEDICAID 3810024041
West Virginia MEDICAID 0069462

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