Doctor Name: | DR. BARBARA ANN MACK |
NPI Number: | 1295866044 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 34388 |
Business Practice Address: | 785 E Massachusetts Ave Southern Pines, NC - 283875719 |
Business Phone Number: | 9102469849 |
Business Fax Number: | |
Mailing Address: | 785 E Massachusetts Ave, SOUTHERN PINES |
State: | NC |
Postal Code: | 283875719 |
Phone Number: | 9102469849 |
Fax Number: | |
NPI Enumeration Date: | 03/07/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 34388 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |