Provider Demographics
NPI:1215927637
Name:NACKMAN, LOUIS J (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:J
Last Name:NACKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18 ORCHARD VIEW DR
Mailing Address - Street 2:ELLIOT PEDIATRICS AT LONDONDERRY
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-6605
Mailing Address - Country:US
Mailing Address - Phone:603-552-1350
Mailing Address - Fax:603-552-1359
Practice Address - Street 1:275 MAMMOTH RD
Practice Address - Street 2:SUITE 2
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109-4133
Practice Address - Country:US
Practice Address - Phone:603-663-8300
Practice Address - Fax:603-663-8349
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH9740208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0107423YPNH01OtherANTHEM ACES PIN
NH2128OtherCIGNA PIN
NH12-40733OtherUHC PIN
NH30009879Medicaid
NH845104OtherAETNA PIN
NHHLO004OtherHPHC PIN
NH406452OtherTUFTS PIN
NHG03404OtherANTHEM REFERRING UPIN
NHP639259OtherOXFORD
NH406452OtherTUFTS PIN
NHRE7496Medicare PIN