CANDRA LANETTE MACK M.D.
NPI 1487703153
Pediatrics in Covington, GA

Q: What is Candra Mack's NPI number?

The NPI number for Candra Mack is 1487703153. It was assigned to this individual provider in the NPPES registry on January 10, 2007.

Q: What is Candra Mack's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Candra Mack was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 10, 2007

4152 BAKER STREET, NE, COVINGTON, GA 30014(770) 788-1077(770) 805-9329 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Candra Lanette Mack M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CANDRA LANETTE MACK M.D. (NPI 1487703153) is an individual pediatrics provider in Covington, Georgia, licensed in Georgia (61000) and active in the NPI registry since January 2007.

NPPES Registry Identity

NPI1487703153

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameCANDRA LANETTE MACKCredential: M.D.

Location Address4152 BAKER STREET, NECovington, GA 30014-1404

Mailing Address4152 Baker Street, NeCovington, GA 30014-1404 · (770) 788-1077 · Fax (770) 805-9329

Phone(770) 788-1077

Fax(770) 805-9329

Sole ProprietorNo

Enumeration DateJanuary 10, 2007

Last NPPES UpdateMarch 7, 2023

✔ NPI 1487703153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Licenses✔ Licensed in GA · 61000✔ Licensed in FL · TRN8908

Definition

A pediatrician 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.

4152 BAKER STREET, NE, Covington, GA 30014

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Other Identifiers 2

Other061000GA · Medical License

Medicaid510091718AGA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Candra Mack's NPI number?

The NPI number for Candra Mack is 1487703153. It was assigned to this individual provider in the NPPES registry on January 10, 2007.

Where is Candra Mack located?

Candra Mack practices at 4152 Baker Street, NE, Covington, GA 30014. The listed phone number is (770) 788-1077.

What is Candra Mack's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Candra Mack was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.