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Organization
SPENCERVILLE PHYSICIANS, LTD
Active
Organization
SPENCERVILLE PHYSICIANS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD O MACK MD (PARTNER)
(419) 647-4188
Entity
Organization
Contact information
Practice address
107 N CANAL ST, SPENCERVILLE, OH 45887-1121
(419) 647-4188
(419) 647-4421
Mailing address
107 N CANAL ST, SPENCERVILLE, OH 45887-1121
(419) 647-4188
(419) 647-4421
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35067497
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2052326
—
OH
Enumeration date
03/12/2007
Last updated
08/22/2020
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