David A Mack, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

DO08469 Issued in OR

Practice address

1810 East 19TH St
Suite 209
The Dalles, OR 97058

Phone

(541) 296-5657

NPI assigned

Nov 14, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1679555908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 E 19TH ST",
            "address_2": "SUITE 209",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583388",
            "telephone_number": "541-296-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 EAST 19TH ST",
            "address_2": "SUITE 209",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "97058",
            "telephone_number": "541-296-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OR",
            "license": "DO08469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227967",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Marie Lucia
• Tim Lundgren
• Debra Lynn Lutje, LMT, CMT
• Brian Christian Macarthur, M.D.
• Katrina Mace
• Dennis Keith Macnab, DMD
• David S Macnally, PA C
• Graci Maddox
• Kathleen Marie Madore, LCSW
• Delia Magana

• Obstetrics & Gynecology Physician in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Obstetrics & Gynecology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.