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Gary Hackett PA-C NPI 1003081258

Classification
Physician Assistant
Type
Surgical
Specialization
Surgical
License No.
PA1110
License State
KY
Certified
Location

Additional Identifiers

Medical School
No
Graduation Year
0
Identifier
Type
State
Identifier: 7100050170
Type: MEDICAID (05)
State: KY
Identifier: 0389221
Type: MEDICARE PIN (08)
State: KY
Identifier: CB8861
Type: OTHER (01)
State: KY
Identifier: P00813821
Type: MEDICARE PIN (08)
State: KY

Hospital & Clinics

Business Name
Company Size
Revenue
Business Address
2845 CHANCELLOR DR, CRESTVIEW HILLS, KY, 410173418
Business Phone
859-426-4200
Mailing Address
560 S LOOP RD, EDGEWOOD, KY, 410173405
Mailing Phone
859-301-2663
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