Healthcare Provider Details

I. General information

NPI: 1255438370
Provider Name (Legal Business Name): BARBARA LYNNE ACKERMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 ENRIGHT AVE
WILLOWS CA
95988
US

IV. Provider business mailing address

PO BOX 103
WILLOWS CA
95988
US

V. Phone/Fax

Practice location:
  • Phone: 530-934-4682
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG84156
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101052686
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG84156
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: