Individual
DR. ETHAN ANDREW HACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2790 CLAY EDWARDS DR STE 520570, NORTH KANSAS CITY, MO 64116-3276
(816) 221-6750
(816) 221-7280
Mailing address
2800 CLAY EDWARDS DRIVE, MEDICAL STAFF SERVICES, NORTH KANSAS CITY, MO 64116
(816) 691-1655
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
94-09160
KS
207RC0000X
Cardiovascular Disease Physician
35503
OK
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
2025032202
MO
Other
Enumeration date
06/09/2017
Last updated
08/22/2025
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