| Pamela J. Hackl, D.o., Plc | |
|
7443 Jackman Rd Temperance MI 48182-9223 | |
| (734) 850-0100 | |
| (734) 850-0112 |
| Full Name | Pamela J. Hackl, D.o., Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 7443 Jackman Rd, Temperance, Michigan |
| Authorized Official Name and Position | Pamela J. Hackl (OWNER) |
| Authorized Official Contact | 7348500100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pamela J. Hackl, D.o., Plc 7443 Jackman Rd Temperance MI 48182-9223 Ph: (734) 850-0100 | Pamela J. Hackl, D.o., Plc 7443 Jackman Rd Temperance MI 48182-9223 Ph: (734) 850-0100 |
| NPI Number | 1306030036 |
|---|---|
| Provider Enumeration Date | 09/06/2007 |
| Last Update Date | 06/13/2022 |
| Medicare PECOS PAC ID | 8224073689 |
|---|---|
| Medicare Enrollment ID | O20050627000151 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306030036 | NPI | - | NPPES |
| DF9366 | Other | OH | RAILROAD MEDICARE |
| 2868704 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5101011928 (Michigan) | Primary |
| Provider Name | Pamela J Hackl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134125024 PECOS PAC ID: 1254238637 Enrollment ID: I20031215000417 |
| Provider Name | Bradley S Ruch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700336781 PECOS PAC ID: 4385924406 Enrollment ID: I20161207001750 |
| Provider Name | Liza J Whitacre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922592369 PECOS PAC ID: 0648520429 Enrollment ID: I20180829003121 |
| Provider Name | Kristi Lorenc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043686710 PECOS PAC ID: 9638488810 Enrollment ID: I20210819001665 |
| Provider Name | Nicole M Hauser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790423887 PECOS PAC ID: 8224406442 Enrollment ID: I20221119000071 |
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