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NPI Code Detail

MEDICARE: DR. JOEL J ACKERMAN O.D.

MEDICARE:  DR. JOEL J ACKERMAN  O.D.
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
1152W00000XOptometrist#5AZ

General Provider Information

NPI Number : 1457337560
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOEL J ACKERMAN O.D.
Provider Business Mailing Address
First Line : 14001 N 7TH ST
Second Line : #B-103
City : PHOENIX
State : AZ
Zip : 85022-4382
Country : US
Telephone Number : 602-993-3400
Fax Number : 602-993-3428
Provider Business Practice Location Address
First Line : 14001 N 7TH ST
Second Line : #B-103
City : PHOENIX
State : AZ
Zip : 85022-4382
Country : US
Telephone Number : 602-993-3400
Fax Number : 602-993-3428
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2005
Last Update Date : 01/12/2010

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Directions to “ DR. JOEL J ACKERMAN O.D.” Practice Location

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