Individual
THOMAS A. HACKENBERG
Active
Individual
THOMAS A. HACKENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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