Individual
DR. TRACI GILES HACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1836 W MAIN ST, DOTHAN, AL 36301-1320
(334) 699-8585
(334) 699-8587
Mailing address
5932 LAKE CYRUS DR, HOOVER, AL 35244-4162
(334) 300-7480
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23561
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51530696
BCBS
AL
05
—
529925720
—
AL
Enumeration date
10/04/2006
Last updated
01/06/2014
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