Dr. Gordon K Mack
MD | Pediatric Cardiology | Male
Dr. Gordon K Mack, MD is a Boise, Idaho based Pediatric doctor with medical specialization in
Pediatric Cardiology.
Current practice location of Dr. Gordon K Mack is
100 E Idaho St, Suite 304, Boise, Idaho - 83712-6267. He can be contacted on phone at
208-381-7384 and fax number 208-381-7387.
Dr. Gordon K Mack is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Gordon K Mack is
1982937058 which was assigned by NPPES on 08 Sep, 2009 and it was last updated on 05 Feb, 2014.
Dr. Gordon K Mack license number is
M-12151 for Pediatrics Pediatric Cardiology (2080P0202X) in Idaho.
Dr. Gordon K Mack provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Complete Profile:
Dr. Gordon K Mack basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Pediatric Cardiology |
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| Provider Name : | Dr. Gordon K Mack |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Dr. Gordon K 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 : | 100 E Idaho St, Suite 304
Boise, ID, 83712-6267
United States |
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| Phone Number : | 208-381-7384 |
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| Fax Number : | 208-381-7387 |
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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 : | 1982937058 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 08 Sep, 2009 |
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| Last Updated On : | 05 Feb, 2014 |
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Medicare Participation:
Dr. Gordon K Mack participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
| Medicare PECOS ID : | 2264570456 |
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| Medicare Enrollment ID : | I20131119000649 |
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| Primary Specialty : | Pediatric Medicine |
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| Medical School : | Other |
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| Graduation Year : | 1994 |
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| Accepts Medicare? | Yes. Dr. Gordon K Mack accepts medicare insurance. |
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Group Practice Association:
Dr. Gordon K Mack is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Dr. Gordon K Mack is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.
| Organisation Name : | Group Practice ID | No. of Members | Practice Address | Group Accepts Medicare |
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| St Lukes Clinic - Treasure Valley Llc | 4981878402 | 884 | 520 S Eagle Rd
Meridian, ID - 836426351 | Yes |
| St Lukes Clinic - Treasure Valley Llc | 4981878402 | 884 | 608 W Hays St
Boise, ID - 837025511
Ph: 2083815970 | Yes |
| St Lukes Clinic - Treasure Valley Llc | 4981878402 | 884 | 610 W Hays St
Boise, ID - 837025511 | Yes |
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 Dr. Gordon K Mack are as mentioned. Primary taxonomy code for Dr. Gordon K Mack, MD is
2080P0202X (Pediatrics Pediatric Cardiology).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080P0202X | Pediatrics Pediatric Cardiology | No | 7320207-1205 | UT |
| 2080P0202X | Pediatrics Pediatric Cardiology | Yes | M-12151 | ID |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Gordon K Mack such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 1982937058 | MEDICAID | ID | |
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 : | 190 E Bannock St
Boise, ID, 83712-6241
United States |
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| Phone Number : | 208-381-2222 |
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Business Location:
Patients can refer following map for directions to
Dr. Gordon K 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.