NPI 1003081258

Gary James Hackett, PAC

Practitioner Surgical Physician Assistant Crestview Hills, KY

Practice location

Address: 2845 Chancellor Dr, Crestview Hills, KY 41017-3418
Phone: (859) 426-4200
Fax: (859) 426-4206
Mailing address: 560 S Loop Rd, Edgewood, KY 41017-3405

Registered specialties

Surgical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AS0400X Licence PA1110 (KY)

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Registry record

NPI: 1003081258
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Apr 2008
Record last updated: 21 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.