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NPI Code Detail

MEDICARE: MEREDITH HACKLEY

MEDICARE: MEREDITH HACKLEY
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
1152W00000XOptometrist1896SC
2152W00000XOptometrist2471NC

General Provider Information

NPI Number : 1043696701
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEREDITH HACKLEY
Provider Business Mailing Address
First Line : 7615 COLONY RD
Second Line : STE 105
City : CHARLOTTE
State : NC
Zip : 28226-5018
Country : US
Telephone Number : 704-443-4444
Fax Number :
Provider Business Practice Location Address
First Line : 200 S COLLEGE ST
Second Line :
City : CHARLOTTE
State : NC
Zip : 28202-2012
Country : US
Telephone Number : 704-443-4444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2015
Last Update Date : 04/27/2017

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Directions to “ MEREDITH HACKLEY ” Practice Location

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