Hackney, Mark A
Hackney, Mark A is an individual health care provider with primary practice located at 700 Village Dr , Fairmont WV 26554-7985. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Hackney, Mark A can be contacted via phone (304) 366-2600.Contact Information
Primary practice address
700 Village Dr
Fairmont WV 26554-7985
Phone: (304) 366-2600
Fax: (304) 366-2080
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 20963 | West Virginia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | TP199 | Kentucky |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 35.087295 | Ohio |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 01061747A | Indiana |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 36114676 | Illinois |
Profile Details
| NPI number | 1275581076 |
|---|---|
| LBN Legal business name | Hackney, Mark A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Jul 19th, 2007 - about 17 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 | 1275581076 | NPPES |
| West Virginia | MEDICAID | 3810001885 | |
| West Virginia | Other | 000000163377 | |
| West Virginia | Other | 1065856 | |
| West Virginia | Other | 000000384890 |
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