Individual
THOMAS A. HACKENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3230 E WOODMEN RD, SUITE 210, COLORADO SPRINGS, CO 80920
(719) 578-5176
(719) 578-5188
Mailing address
3230 E WOODMEN RD, SUITE 210, COLORADO SPRINGS, CO 80920
(719) 578-5176
(719) 578-5188
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
35232
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01352327
—
CO
01
—
0970329
AETNA
CO
01
—
41366
BLUE CROSS
CO
01
—
440001691
RAIL ROAD MEDICARE
CO
Enumeration date
07/21/2005
Last updated
06/11/2013
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