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General NPI Number Information
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NPI Number | 1912931031
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Entity Type | Individual
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Provider Name | JOSEPH A MACK M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 12/21/2025
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Provider Practice Location Address
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Address Line | 49 2ND ST
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City | PRESQUE ISLE
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State | ME
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Zip | 04769-2637
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Country | US
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Telephone | 207-762-4641
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Fax | 207-762-3336
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Provider Business Mailing Address
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Address Line | 54 3RD ST
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City | PRESQUE ISLE
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State | ME
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Zip | 04769-2649
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Country | US
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Telephone | 207-762-6027
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 013912
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License Number State | ME
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