Individual
PHILIP WILLIAM MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
516 CAREW ST, SPRINGFIELD, MA 01104-2330
(413) 787-2047
(413) 787-2054
Mailing address
516 CAREW ST, SPRINGFIELD, MA 01104-2330
(413) 787-2047
(413) 787-2054
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
208323
MA
207XP3100X
Pediatric Orthopaedic Surgery Physician
050085
CT
Other
Enumeration date
12/05/2005
Last updated
04/11/2022
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