MEDICARE: CURTIS F MACK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	25000	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568411890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CURTIS F MACK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 910221
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75391-0221
Country	:	US
Telephone Number	:	520-519-7700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1845 W ORANGE GROVE RD
Second Line	:	BLDG 1
City	:	TUCSON
State	:	AZ
Zip	:	85704-1134
Country	:	US
Telephone Number	:	520-544-2919
Fax Number	:	520-544-2943

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	03/16/2022

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