Mr Keith J Hacker, PA in Port Washington, WI

Mr Keith J Hacker, PA is a Physician Assistant based in Port Washington, Wisconsin. Mr Keith J Hacker is licensed to practice in Wisconsin (license number 523) and his current practice location is 1777 W Grand Ave, Port Washington, Wisconsin. He can be reached at his office (for appointments etc.) via phone at (262) 284-3456.

NPI number for Mr Keith J Hacker is 1952508400 and his current mailing address is 1777 W Grand Ave, Port Washington, Wisconsin. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1952508400.

Contact Information

	Mr Keith J Hacker, PA
	1777 W Grand Ave, Port Washington, WI 53074-2077
	(262) 284-3456
	Not Available

Map and Direction

Provider's Profile

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.

NPI Data:

NPI Number: 1952508400
Provider Enumeration Date: 06/28/2007
Last Update Date: 11/23/2021

Medical Identifiers

Medical identifiers for Mr Keith J Hacker such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1952508400	NPI	-	NPPES
1952508400	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	523 (Wisconsin)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Keith J Hacker is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

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

Reviews and Comments

Physician Assistant Nurses in Port Washington, WI

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
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

Mr Keith J Hacker, PA - Physician Assistant in Port Washington, WI