| Doctor Name: | DR. MICHAEL JOSPEH ACKLEY |
| NPI Number: | 1114928074 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 395 |
| Business Practice Address: | 714 S Main St Cheshire, CT - 064103448 |
| Business Phone Number: | 2032710556 |
| Business Fax Number: | 2032509951 |
| Mailing Address: | 714 S Main St, CHESHIRE |
| State: | CT |
| Postal Code: | 064103448 |
| Phone Number: | 2032710556 |
| Fax Number: | 2032509951 |
| NPI Enumeration Date: | 08/02/2005 |
| NPI Last Update Date: | 11/14/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 03/21/2006 |
| NPI Reactivation Date: | 04/13/2006 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0000X |
| License Number: | 395 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Sports Medicine |
| Taxonomy Definition: | |