Individual
DOROTHY M MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, PA-C
Contact information
Practice address
655 7TH ST, ROBINS AFB, GA 31098-2227
(478) 327-7805
(478) 327-7816
Mailing address
655 7TH ST, ROBINS AFB, GA 31098-2227
(478) 327-7805
(478) 327-7816
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003043
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505983680C
—
GA
Enumeration date
08/08/2006
Last updated
03/31/2022
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