Hacker, Richard Keith

Hacker, Richard Keith is an individual health care provider with primary practice located at 412 Como Rd , Lake Como PA 18437-1020. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hacker, Richard Keith can be contacted via phone (570) 798-2828.

Contact Information

Primary practice address
412 Como Rd Lake Como PA 18437-1020
Fax: (570) 798-2636
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD4287949 Pennsylvania

Profile Details

NPI number 1013959675
LBN Legal business name Hacker, Richard Keith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2006
Last updated Sep 15th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013959675 NPPES
Pennsylvania MEDICAID 1018670380007

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