Healthcare Provider Details

I. General information

NPI: 1598686941
Provider Name (Legal Business Name): ADAM HACKETT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 ENNIS ST
SARALAND AL
36571-2706
US

IV. Provider business mailing address

119 ENNIS ST
SARALAND AL
36571-2706
US

V. Phone/Fax

Practice location:
  • Phone: 251-320-3363
  • Fax:
Mailing address:
  • Phone: 251-320-3363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberALC06110
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: