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Individual

DR. ALICE JODY ACKERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1 HEALTHCARE DR, MANSFIELD HILL, PHILIPPI, WV 26416
(304) 457-1760
(304) 457-3781
Mailing address
1 HEALTHCARE DR, MANSFIELD HILL, PHILIPPI, WV 26416-9405
(304) 457-1760
(304) 457-3781

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2159
WV
207Q00000X
Family Medicine Physician
05-009868-L
PA
207Q00000X
Family Medicine Physician
2159
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001782911 (00008)
PA
01
001817913
MOUNTAIN STATE BCS
WV
05
3810004790
WV
01
P00375987
RAILROAD MEDICARE
01
WV02159A
THE HEALTH PLAN
Enumeration date
02/02/2006
Last updated
04/01/2020
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