Provider Demographics
NPI:1538185582
Name:HACKMAN, BARBARA B (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:B
Last Name:HACKMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 FORREST LN
Mailing Address - Street 2:
Mailing Address - City:STRAFFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19087-2504
Mailing Address - Country:US
Mailing Address - Phone:610-651-7760
Mailing Address - Fax:610-644-7517
Practice Address - Street 1:209 W LANCASTER AVE
Practice Address - Street 2:SUITE #101
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1749
Practice Address - Country:US
Practice Address - Phone:610-651-7760
Practice Address - Fax:610-644-7517
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD072634L207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001300519OtherHIGHMARK BS
PA0894882000OtherINDEPENDENCE BC
PA0007349249OtherAETNA
PAH45603Medicare UPIN
PA0894882000OtherINDEPENDENCE BC