Individual
DR. MARK S MCCRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1499 FAIR RD, STATESBORO, GA 30458-1683
(912) 486-1430
(912) 871-2262
Mailing address
1499 FAIR RD, STATESBORO, GA 30458-1683
(912) 839-2810
(912) 839-2808
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
055863
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
391955373A
—
GA
Enumeration date
11/28/2006
Last updated
07/21/2016
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