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Individual

DR. JOSEPH MICHAEL MACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1024 S LEMAY AVE, FORT COLLINS, CO 80524-3929
(970) 484-4757
Mailing address
2008 CARIBOU DR, FORT COLLINS, CO 80525-4325
(970) 484-4757
(970) 484-4759

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
17609C
WY
2085R0202X
Diagnostic Radiology Physician
Primary
58275
GA
2085R0202X
Diagnostic Radiology Physician
CDR.0004506
CO
2085R0202X
Diagnostic Radiology Physician
CP1090
NE

Other

Enumeration date
12/28/2005
Last updated
03/08/2025
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