| Hackett Medical Ltd | |
|
8300 Tyler Blvd Suite 300 Mentor OH 44060-4217 | |
| (440) 205-1529 | |
| (440) 205-0840 |
| Full Name | Hackett Medical Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 8300 Tyler Blvd, Mentor, Ohio |
| Authorized Official Name and Position | Martha Nofziger Hackett (OWNER HACKETT MEDICAL LTD.) |
| Authorized Official Contact | 4402051529 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hackett Medical Ltd 8300 Tyler Blvd Suite 300 Mentor OH 44060-4217 Ph: (440) 205-1529 | Hackett Medical Ltd 8300 Tyler Blvd Suite 300 Mentor OH 44060-4217 Ph: (440) 205-1529 |
| NPI Number | 1114071206 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 08/03/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114071206 | NPI | - | NPPES |
| 2178905 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35043939 (Ohio) | Secondary |
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