Provider Demographics
NPI:1487724068
Name:HACKER, JOSEPH F III (MD,FACP,FACG)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:HACKER
Suffix:III
Gender:M
Credentials:MD,FACP,FACG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BRENDLE LN
Mailing Address - Street 2:CARILLON
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807-1300
Mailing Address - Country:US
Mailing Address - Phone:302-428-0779
Mailing Address - Fax:
Practice Address - Street 1:4745 OGLETOWN STANTON RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2067
Practice Address - Country:US
Practice Address - Phone:302-738-5300
Practice Address - Fax:302-731-4822
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0003074174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
B66414Medicare UPIN
94332G56Medicare ID - Type Unspecified