Provider Demographics
NPI:1841256658
Name:MICHAEL K. ACKLAND, MD
Entity type:Organization
Organization Name:MICHAEL K. ACKLAND, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:KINGSLEY
Authorized Official - Last Name:ACKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-888-6907
Mailing Address - Street 1:449 ROUTE 130
Mailing Address - Street 2:STE 8
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563
Mailing Address - Country:US
Mailing Address - Phone:508-888-6907
Mailing Address - Fax:508-888-6948
Practice Address - Street 1:449 ROUTE 130
Practice Address - Street 2:STE 8
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563
Practice Address - Country:US
Practice Address - Phone:508-888-6907
Practice Address - Fax:508-888-6948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2007-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1845471207XX0005X
MA76697207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA738157OtherTUFTS
MAJ13172OtherBLUE CROSS MASS
MA17866OtherPILGRIM
MA17866OtherPILGRIM
J13172Medicare PIN