Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1861993552 Individual Practitioner Male Practitioner

Dr. Douglas Timothy Mack , MD

Otolaryngology • Apo, AA

Professional Overview & Biography Verified Profile Summary

Dr. Douglas Mack, MD is a registered healthcare professional specializing in Otolaryngology in Apo, AA. Practice services are available at 4076 NEELY RD. under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4076 Neely Rd.

Apo, AA 99703

Telephone 9073615172
Associated Practice Facility / Clinic
🏢 Ach Bassett-Wainwright Facility NPI 1699877993

Specialty Benchmarks & Practice Insights

Comparative analytics for Otolaryngology in Apo, AA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Apo, AA (1 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-06-17
Otolaryngology Primary Specialty

NUCC Taxonomy Code: 207Y00000X

State License NE 32380

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Otolaryngology

NUCC Taxonomy Code: 207Y00000X

State License MN 78320

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Secondary Practice Locations

400 E 3rd St

Duluth, MN 558051951

Phone: 2187868364

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners
Dr. Nathan Bastien , MD

General Practice

NPI 1134659394

Doctor of Medicine (M.D.)

Karlene Sierra , FNP-BC

Nurse Practitioner - Family

NPI 1215771241

Family Nurse Practitioner (Board Certified)

Dr. John Bass , MD

Emergency Medicine

NPI 1255724274

Doctor of Medicine (M.D.)

Stephen Callahan , PA-C

Physician Assistant

NPI 1285082552

Physician Assistant (Certified)

NPI 1295272417

Doctor of Osteopathic Medicine (D.O.)

Dr. James Jordan , MD

Orthopaedic Surgery

NPI 1396368197

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

16 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 10, 2024

Otolaryngology (License #78320 in MN)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 11, 2023

Otolaryngology (License #32380 in NE)

📍
Updated Practice Location July 05, 2023

Registered at 4076 NEELY RD., APO, AA 99703 (Tel: 9073615172)

📍
Updated Business Mailing Address July 05, 2023

Registered at 4076 NEELY ROAD, FORT WAINWRIGHT, TX 99703 (Tel: 9073615172)

👤
Provider Name / Credentials Updated March 13, 2020

Recorded as DOUGLAS MACK, MD

NPI Profile Active March 17, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location March 17, 2018

Registered at 3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 782344504 (Tel: 2109163910)

📍
Updated Business Mailing Address March 17, 2018

Registered at 3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 782344504 (Tel: 2109163910)

👤
Provider Name / Credentials Updated March 17, 2018

Recorded as DOUGLAS MACK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2018

Student in an Organized Health Care Education/Training Program

NPI Profile Active February 27, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location February 27, 2018

Registered at 3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 782344504 (Tel: 2109163910)

📍
Updated Business Mailing Address February 27, 2018

Registered at 3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 782344504 (Tel: 2109163910)

👤
Provider Name / Credentials Updated February 27, 2018

Recorded as DOUGLAS MACK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 27, 2018

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration February 27, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1861993552
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 27, 2018
Last Update: June 17, 2026
Sole Proprietor: No

Mailing Address

4076 Neely Road

Fort Wainwright, TX 99703

Phone: 9073615172

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.