NPI age
16 years
Enumerated 2009-09-08
● Active
Type 1 · Individual
DR. Gordon K MacK, MD
MacK is 1 of 6 pediatrics providers in Boise and 1 of 15 in Idaho.
Primary specialty
Pediatrics
Plus 1 subspecialty
Licensed in
ID, UT
2 states
Status
Active
No deactivations on record
Last NPPES update
2014-02-05
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 15 active pediatrics providers in Idaho.
NPI age
16 years
≈ at median (16 yr)
State licenses
2 states
Top 80% — 20% of peers are multi-state
Subspecialties
0
26% of peers hold subspecialties
NPI lifetime · 2009 → 2026
2009-09Enumerated in NPPES
2009
2026
Where they practice
Practice location
100 E Idaho St, Suite 304
Boise, ID 837126267
Mailing address
190 E Bannock St
Boise, ID 837126241
Specialties
-
Pediatrics PrimaryA 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,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1982937058 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 186 other active providers share this practice address in NPPES.
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