Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Anthony J Mack, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1679268635

Anthony J Mack, DO is an Emergency Medicine in Fairborn, Ohio. Graduated from Kansas City University of Med & Biosciences, College of Osteo Med in 2023, 3 years ago. Registered with an NPI since 2023.

Years since qualifying
3
Trained at
Kansas City University of Med & Biosciences, College of Osteo Med
In the registry since
2023
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2555 University Dr
Fairborn, OH 45324-6255
Phone: (937) 775-8188
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1679268635
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 6, 2023
Last updated in NPPESApril 6, 2023
Certification dateApril 6, 2023
Mailing address2555 University Dr, Fairborn, OH 45324-6255

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolKANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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