Provider Demographics
NPI:1760791396
Name:JAMES A HACKELY OD, LLC
Entity type:Organization
Organization Name:JAMES A HACKELY OD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:HACKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:614-847-3912
Mailing Address - Street 1:1150 POLARIS PKWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-2024
Mailing Address - Country:US
Mailing Address - Phone:614-847-3912
Mailing Address - Fax:614-847-4138
Practice Address - Street 1:1150 POLARIS PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-2024
Practice Address - Country:US
Practice Address - Phone:614-847-3912
Practice Address - Fax:614-847-4138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5864261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery