MR. Keith J Hacker, P.A.

NPI #1952508400 in Port Washington, Wisconsin

Provider Information

NPI Number: 1952508400
Entity Type: Individual
Name: MR. Keith J Hacker, P.A.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A.
Enumeration Date: Jun 28, 2007
Last Updated: Nov 23, 2021

Practice Location

Address: 1777 W GRAND AVE
City: Port Washington
State: Wisconsin
ZIP Code: 53074-2077
Phone: (262) 284-3456

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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