Individual
DR. ALEICIA RAE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3433 NW 56TH ST, STE 400, OKLAHOMA CITY, OK 73112-4455
(405) 947-3341
(405) 945-3126
Mailing address
DEPT 96-0372, OKLAHOMA CITY, OK 73196-0372
(405) 951-4370
(405) 949-9120
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
53258-21
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/27/2007
Last updated
09/28/2012
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