Individual
DR. WILLIAM JOSEPH MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11111 NALL AVE, SUITE 103, LEAWOOD, KS 66211-1924
(913) 314-3495
Mailing address
11111 NALL AVE, SUITE 103, LEAWOOD, KS 66211-1924
(913) 314-3495
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
04-35486
KS
2084P0800X
Psychiatry Physician
2011036813
MO
Other
Enumeration date
06/05/2006
Last updated
06/22/2012
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