Ackley, Michael Jospeh
Ackley, Michael Jospeh is an sole proprietor health care provider with primary practice located at 714 S Main St , Cheshire CT 06410-3448. He recently has 4 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Foot Surgery, Suppliers / Durable Medical Equipment & Medical Supplies. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is his primary health care specialty. Ackley, Michael Jospeh can be contacted via phone (203) 271-0556.Contact Information
Primary practice address
714 S Main St
Cheshire CT 06410-3448
Phone: (203) 271-0556
Fax: (203) 250-9951
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine | 213EP1101X | 395 | Connecticut |
| Podiatric Medicine & Surgery Service Providers / Sports Medicine | 213ES0000X | 395 | Connecticut |
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | 395 | Connecticut |
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 395 | Connecticut |
Profile Details
| NPI number | 1114928074 |
|---|---|
| LBN Legal business name | Ackley, Michael Jospeh |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 2nd, 2005 |
| Last updated | Nov 14th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114928074 | NPPES |
| Connecticut | Other | 030000395CT01 | ANTHEM BCBS |
| Connecticut | Other | 2V1300 | ANTHEM BCBS |
| Connecticut | Other | 480028957 | ANTHEM BCBS |
| Connecticut | Other | 0542290 | ANTHEM BCBS |
| Connecticut | Other | 129286 | ANTHEM BCBS |
| Connecticut | Other | 129286 | ANTHEM BCBS |
| Connecticut | Other | 2721297 | ANTHEM BCBS |
| Connecticut | Other | NHS221 | ANTHEM BCBS |
| Connecticut | Other | 787023 | ANTHEM BCBS |
| Connecticut | MEDICAID | 4068714 | ANTHEM BCBS |
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