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General NPI Number Information
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NPI Number | 1215927637
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Entity Type | Individual
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Provider Name | LOUIS J. NACKMAN MD
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 01/27/2011
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Provider Practice Location Address
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Address Line | 275 MAMMOTH RD SUITE 2
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City | MANCHESTER
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State | NH
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Zip | 03109-4133
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Country | US
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Telephone | 603-663-8300
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Fax | 603-663-8349
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Provider Business Mailing Address
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Address Line | 18 ORCHARD VIEW DR ELLIOT PEDIATRICS AT LONDONDERRY
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City | LONDONDERRY
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State | NH
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Zip | 03053-6605
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Country | US
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Telephone | 603-552-1350
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Fax | 603-552-1359
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 9740
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License Number State | NH
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