Provider Demographics
NPI:1043271067
Name:HACKMAN, JOHN E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:HACKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1722 PINE STREET
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1107
Mailing Address - Country:US
Mailing Address - Phone:334-834-1663
Mailing Address - Fax:334-834-1936
Practice Address - Street 1:1722 PINE STREET
Practice Address - Street 2:SUITE 1001
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1107
Practice Address - Country:US
Practice Address - Phone:334-834-1663
Practice Address - Fax:334-834-1936
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7331174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC74551Medicare UPIN