NPI 1013658699

Jonathan Charles Lee Mack, MD

Practitioner Family Medicine Physician Winston Salem, NC

Practice location

Address: 390 W Salem Ave, Winston Salem, NC 27101-5861
Phone: (336) 721-2375
Fax: (336) 721-2394
Mailing address: PO Box 60447, Charlotte, NC 28260-0447

Registered specialties (2)

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 2025-01755 (NC)

Other Family Medicine providers in North Carolina →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1013658699
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Apr 2022
Record last updated: 16 Jul 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.