National Provider Identifier Database

GORDON K MACK, MD – NPI #1982937058
Pediatric Cardiology

A pediatric cardiologist 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.


Contact Information

GORDON K MACK, MD
100 E IDAHO ST
SUITE 304
BOISE, ID83712-6267
Phone: 208-381-7384
Fax: 208-381-7387
Website:
Specialty Taxonomy Code
* Pediatric Cardiology 2080P0202X

* Indicates primary specialty

NPI Profile & details for GORDON K MACK

NPI Number 1982937058
Credentials MD
Entity Individual
Enumeration date 09/08/2009
Last updated 02/05/2014 - About 12 years ago
Sole proprietor1 No
Identifiers
  • ID License #: M-12151
  • UT License #: 7320207-1205
  • ID Medicaid: 1982937058
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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