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Individual
BENJAMIN J HACKETT
Active
Individual
BENJAMIN J HACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
102356
MN
207X00000X
Orthopaedic Surgery Physician
Primary
50024-20
WI
207XS0117X
Orthopaedic Surgery of the Spine Physician
50024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102356
TEMP LICENSE
MN
Enumeration date
06/23/2006
Last updated
06/17/2021
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