Individual
LAMAR OCTAVIUS MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 S AKERS ST, STE 120, VISALIA, CA 93277-8306
(559) 625-4118
(559) 625-6004
Mailing address
820 S AKERS ST, STE 120, VISALIA, CA 93277-8306
(559) 625-4118
(559) 625-6004
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
A123815
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
TN
Other
Enumeration date
07/24/2008
Last updated
02/11/2021
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