Provider Demographics
NPI:1972653434
Name:ACKER, JAMES H (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:ACKER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1275 W GRANADA BLVD
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8259
Mailing Address - Country:US
Mailing Address - Phone:386-672-7850
Mailing Address - Fax:386-274-1926
Practice Address - Street 1:141 SAGEBRUSH TRL
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8115
Practice Address - Country:US
Practice Address - Phone:386-672-7850
Practice Address - Fax:386-274-1926
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME53344207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05907Medicare PIN
D51450Medicare UPIN