Ackley, Brittany
Ackley, Brittany is an individual health care provider with primary practice located at 3502 Richmond Rd , Texarkana TX 75503-0705. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Ackley, Brittany can be contacted via phone (903) 614-5270.Contact Information
Primary practice address
3502 Richmond Rd
Texarkana TX 75503-0705
Phone: (903) 614-5270
Fax: (903) 614-5279
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | R4928 | Texas |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 760422435 | Texas |
Profile Details
NPI number | 1295155844 |
---|---|
LBN Legal business name | Ackley, Brittany |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 22nd, 2014 |
Last updated | May 7th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1295155844 | NPPES |
Texas | Other | P02599414 | RR MCR |
Texas | MEDICAID | 200883090A | RR MCR |
Texas | Other | 716046242 | RR MCR |
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