MEDICARE: LOUIS J. NACKMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	9740	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0107423YPNH01	OTHER	NH	ANTHEM ACES PIN
2	2128	OTHER	NH	CIGNA PIN
3	12-40733	OTHER	NH	UHC PIN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	845104	OTHER	NH	AETNA PIN
6	HLO004	OTHER	NH	HPHC PIN
7	406452	OTHER	NH	TUFTS PIN
8	G03404	OTHER	NH	ANTHEM REFERRING UPIN
9	P639259	OTHER	NH	OXFORD

General Provider Information

NPI Number	:	1215927637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS J. NACKMAN MD

Provider Business Mailing Address
First Line	:	18 ORCHARD VIEW DR
Second Line	:	ELLIOT PEDIATRICS AT LONDONDERRY
City	:	LONDONDERRY
State	:	NH
Zip	:	03053-6605
Country	:	US
Telephone Number	:	603-552-1350
Fax Number	:	603-552-1359

Provider Business Practice Location Address
First Line	:	275 MAMMOTH RD
Second Line	:	SUITE 2
City	:	MANCHESTER
State	:	NH
Zip	:	03109-4133
Country	:	US
Telephone Number	:	603-663-8300
Fax Number	:	603-663-8349

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	01/27/2011

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Directions to “ LOUIS J. NACKMAN MD” Practice Location

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