Individual
PETER HACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W PACIFIC STREET, TELLURIDE, CO 81435
(970) 728-3848
(970) 728-3404
Mailing address
PO BOX 1229, TELLURIDE, CO 81435-1229
(970) 728-3848
(970) 728-3404
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34362
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01343623
—
CO
Enumeration date
08/30/2006
Last updated
01/17/2008
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