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DR. MICHAEL JOSPEH ACKLEY DPM
Primary Podiatric Medicine >> Podiatrist >> Podiatric Medicine & Surgery Service ProvidersRegistrant NPI Number: 1114928074
Individual Registrant:DR. MICHAEL JOSPEH ACKLEY DPM
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
714 S MAIN ST CHESHIRE, CT 06410-3448 US
Tel: 203-271-0556 Fax: 203-250-9951
Tel: 203-271-0556 Fax: 203-250-9951
Contact information for business:
714 S MAIN ST CHESHIRE, CT 06410-3448 US
Tel: 203-271-0556 Fax: 203-250-9951
Tel: 203-271-0556 Fax: 203-250-9951
Registration Information:
NPI: 1114928074
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 213EP1101X | Podiatric Medicine & Surgery Service Providers Podiatrist Primary Podiatric Medicine | CT | 395 |
| N | 213ES0000X | Podiatric Medicine & Surgery Service Providers Podiatrist | CT | 395 |
| N | 213ES0131X | Podiatric Medicine & Surgery Service Providers Podiatrist | CT | 395 |
| N | 332B00000X | Suppliers Durable Medical Equipment & Medical Supplies | CT | 395 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| ANTHEM BCBS | 030000395CT01 | CT | 01 |
| AETNA | 2721297 | CT | 01 |
| FIRST CHOICE PREF ONE | 129286 | CT | 01 |
| MEDICARE RAILROAD | 480028957 | CT | 01 |
| CIGNA | 0542290 | CT | 01 |
| CONNECTICARE | 787023 | CT | 01 |
| 4068714 | CT | 05 | |
| WELLCARE | 129286 | CT | 01 |
| HEALTHNET | 2V1300 | CT | 01 |
| OXFORD HEALTH PLAN | NHS221 | CT | 01 |
