Hackman, Vicki Lou

Hackman, Vicki Lou is an individual health care provider with primary practice located at 305 Estill St , Berea KY 40403-1742. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Hackman, Vicki Lou can be contacted via phone (859) 985-1415.

Contact Information

Primary practice address
305 Estill St Berea KY 40403-1742
Phone: (859) 985-1415
Fax: (859) 986-6752
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 24411 Kentucky

Profile Details

NPI number 1215913520
LBN Legal business name Hackman, Vicki Lou
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2005
Last updated Feb 14th, 2014 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215913520 NPPES
Kentucky MEDICAID 64244114

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