| Mr Keith J Hacker, PA | |
|
1777 W Grand Ave, Port Washington, WI 53074-2077 | |
| (262) 284-3456 | |
| Not Available |
| Full Name | Mr Keith J Hacker |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 1777 W Grand Ave, Port Washington, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952508400 | NPI | - | NPPES |
| 1952508400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 523 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Keith J Hacker, PA 1777 W Grand Ave, Port Washington, WI 53074-2077 Ph: (262) 284-3456 | Mr Keith J Hacker, PA 1777 W Grand Ave, Port Washington, WI 53074-2077 Ph: (262) 284-3456 |
Jessica Kristine Conmey, PA- C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1329 W Grand Ave Ste 4, Port Washington, WI 53074 Phone: 262-536-4344 Fax: 262-536-4348 | |
Ms. Anjuli Marie Tuscano, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1777 W Grand Ave, Port Washington, WI 53074 Phone: 262-284-3456 | |
Amanda Lugo, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1037 S Spring Street, Apt 257, Port Washington, WI 53074 Phone: 920-254-1939 | |
Alesha J Ewig, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1475 W Grand Ave, Port Washington, WI 53074 Phone: 262-268-5100 |