Provider Demographics
NPI:1396159208
Name:SAVAGE, MACK WESTON (MD)
Entity type:Individual
Prefix:DR
First Name:MACK
Middle Name:WESTON
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:515 S KENTUCKY AVE STE D
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-4224
Mailing Address - Country:US
Mailing Address - Phone:816-266-4213
Mailing Address - Fax:816-559-8992
Practice Address - Street 1:515 S KENTUCKY AVE STE D
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-4224
Practice Address - Country:US
Practice Address - Phone:816-266-4213
Practice Address - Fax:816-559-8992
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301114302207W00000X, 207WX0107X
MO2015021642207W00000X, 207WX0107X, 207WX0107X
KS04-42791207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200029772Medicaid