Provider Demographics
NPI:1942280904
Name:HACKEL, JOSEPH G (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:G
Last Name:HACKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6039
Mailing Address - Street 2:
Mailing Address - City:FALMARTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-6039
Mailing Address - Country:US
Mailing Address - Phone:888-302-3045
Mailing Address - Fax:207-347-7401
Practice Address - Street 1:2001 WESTSIDE PARKWAY
Practice Address - Street 2:SUITE 290
Practice Address - City:ALPHORETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-8514
Practice Address - Country:US
Practice Address - Phone:877-376-7284
Practice Address - Fax:207-347-7401
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86213207ZP0102X, 207ZD0900X
GA058748207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH45194Medicare UPIN
TX8D1191Medicare PIN