DR. FREDERICK ERWIN HACKLEY M.D. NPI 1104963800

NPI Information

  • NPI: 1104963800
  • Provider Name: DR. FREDERICK ERWIN HACKLEY, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • Address: 8535 MYRTLELAKE DR
    BATON ROUGE, LA
    ZIP 70810
  • Phone: (225) 810-6320

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NPI Details

DR. Frederick Erwin Hackley, M.D. is a family medicine in Baton Rouge, LA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Frederick Erwin Hackley, M.D. NPI is 1104963800. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8535 MYRTLELAKE DR
BATON ROUGE, LA
ZIP 70810-631
Phone: (225) 810-6320

The enumeration date for this NPI number is 1/31/2007 and was last updated on 5/31/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineMD.05798RLOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11321460MEDICAIDLOUISIANA
25B061MEDICARE ID-TYPE UNSPECIFIEDLOUISIANAGROUP MEDICARE NUMBER
3521676629MEDICARE PINLOUISIANA
405798ROTHERLOUISIANASTATE LICENSE
552167MEDICARE PINLOUISIANA
604807394MEDICAIDMISSISSIPPI
7B63651MEDICARE UPINLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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