Provider Demographics
NPI:1508000167
Name:MACK, MENDY ACANTHE (MD)
Entity type:Individual
Prefix:DR
First Name:MENDY
Middle Name:ACANTHE
Last Name:MACK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2708 S RIFE MEDICAL LN
Mailing Address - Street 2:SUITE T40
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-1452
Mailing Address - Country:US
Mailing Address - Phone:479-338-4000
Mailing Address - Fax:479-338-4050
Practice Address - Street 1:2708 S RIFE MEDICAL LN
Practice Address - Street 2:SUITE T40
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1452
Practice Address - Country:US
Practice Address - Phone:479-338-4000
Practice Address - Fax:479-338-4050
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2013-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARE-8012207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology