Individual
DR. MARK DOUGLAS STRACKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MS, MPH
Contact information
Practice address
45 GOLD MINE RD, ROXBURY, CT 06783-1214
(706) 718-8056
Mailing address
45 GOLD MINE RD, ROXBURY, CT 06783-1214
(706) 718-8056
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
060311
GA
2084P0800X
Psychiatry Physician
277716
NY
2084P0800X
Psychiatry Physician
Primary
54602
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
567393386A
—
GA
Enumeration date
12/28/2006
Last updated
09/16/2015
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