Individual
DR. TRACI BOYD ACKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
401 6TH AVE, SUITE 100, MONTGOMERY, WV 25136-2116
(304) 442-7427
(304) 442-0212
Mailing address
401 6TH AVE, SUITE 100, MONTGOMERY, WV 25136-2116
(304) 442-7427
(304) 442-0212
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20405
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1802460000
—
WV
Enumeration date
04/12/2006
Last updated
06/09/2020
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