MEDICARE: JAMES AARON HACKLEY O.D.

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
1	152W00000X	Optometrist	5864	OH

General Provider Information

NPI Number	:	1740410323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES AARON HACKLEY O.D.

Provider Business Mailing Address
First Line	:	21 SUGARBUSH CT
Second Line	:
City	:	ASHLAND
State	:	OH
Zip	:	44805-9737
Country	:	US
Telephone Number	:	419-289-6466
Fax Number	:

Provider Business Practice Location Address
First Line	:	637 N UNION ST
Second Line	:
City	:	LOUDONVILLE
State	:	OH
Zip	:	44842-1074
Country	:	US
Telephone Number	:	419-994-4287
Fax Number	:	419-281-4067

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2009
Last Update Date	:	02/26/2025

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