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General NPI Number Information
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NPI Number | 1154328227
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Entity Type | Individual
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Provider Name | JAMES WILSON HACKLER D.D.S
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Gender | Male
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 3811 E. 51 ST.
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City | TULSA
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State | OK
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Zip | 74135-3603
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Country | US
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Telephone | 918-492-1780
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Fax | 918-492-7823
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Provider Business Mailing Address
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Address Line | 3811 E. 51 ST.
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City | TULSA
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State | OK
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Zip | 74135-3603
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Country | US
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Telephone | 918-492-1780
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Fax | 918-492-7823
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 3465
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License Number State | OK
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