Mack Occupational Health Services SC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MACK OCCUPATIONAL HEALTH SERVICES SC

Practice address

N528 Fairland Island
Menominee, MI 49858

Phone

(906) 424-4089

NPI assigned

Apr 15, 2009

Last updated

Jun 3, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thomas V. Mack, M.D.

Title

Ceo

Phone

(906) 424-4089

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243987200000",
    "number": "1962645226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2643 LIBAL STREET",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54301",
            "telephone_number": "920-435-1604",
            "fax_number": "920-435-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N528 FAIRLAND ISLAND",
            "city": "MENOMINEE",
            "state": "MI",
            "postal_code": "49858",
            "telephone_number": "906-424-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACK OCCUPATIONAL HEALTH SERVICES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-15",
        "last_updated": "2009-06-03",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "906-424-4089",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Menominee, MI
• Providers in Menominee, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; 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.