Ackley, Jacqueline Longbotham

Ackley, Jacqueline Longbotham is an individual health care provider with primary practice located at 118 W Castle Ln , San Antonio TX 78213-1803. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Ackley, Jacqueline Longbotham can be contacted via phone (210) 341-6556.

Contact Information

Primary practice address
118 W Castle Ln San Antonio TX 78213-1803
Phone: (210) 341-6556
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X G7549 Texas

Profile Details

NPI number 1912987660
LBN Legal business name Ackley, Jacqueline Longbotham
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2006
Last updated May 5th, 2017 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912987660 NPPES
Texas MEDICAID 129409206
Texas Other P00902937

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