-- Candra Lanette Mack --
M.D. | Pediatrics | Female
-- Candra Lanette Mack --, M.D. is a Covington, Georgia based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of -- Candra Lanette Mack -- is
4152 Baker Street, Ne, Covington, Georgia - 30014-1404. She can be contacted on phone at
770-788-1077 and fax number 770-805-9329.
-- Candra Lanette Mack -- is a sole proprietor of her business.
NPI number (Unique professional ID) for -- Candra Lanette Mack -- is
1487703153 which was assigned by NPPES on 10 Jan, 2007 and it was last updated on 07 Mar, 2023.
-- Candra Lanette Mack -- license number is
61000 for Pediatrics (208000000X) in Georgia.
-- Candra Lanette Mack -- is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
-- Candra Lanette Mack -- basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | -- Candra Lanette Mack -- |
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| Credential : | M.D. |
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| Gender : | Female |
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Business Address:
-- Candra Lanette Mack -- address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 4152 Baker Street, Ne
Covington, GA, 30014-1404
United States |
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| Phone Number : | 770-788-1077 |
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| Fax Number : | 770-805-9329 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1487703153 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 10 Jan, 2007 |
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| Last Updated On : | 07 Mar, 2023 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for -- Candra Lanette Mack -- are as mentioned. Primary taxonomy code for -- Candra Lanette Mack --, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | No | TRN8908 | FL |
| 208000000X | Pediatrics | Yes | 61000 | GA |
Legacy Identifiers:
Other legacy medical identifiers of -- Candra Lanette Mack -- such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 061000 | Other (non-Medicare) | GA | MEDICAL LICENSE |
| 510091718A | MEDICAID | GA | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 4152 Baker Street, Ne
Covington, GA, 30014-1404
United States |
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| Phone Number : | 770-788-1077 |
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| Fax Number : | 770-805-9329 |
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Business Location:
Patients can refer following map for directions to
-- Candra Lanette Mack -- practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.