Individual
JOSEPH T. HAZUKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3027 N. CIRCLE DR., COLORADO SPRINGS, CO 80909
(719) 776-4646
(719) 776-4640
Mailing address
3027 N. CIRCLE DR., COLORADO SPRINGS, CO 80909
(719) 776-4646
(719) 776-4640
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2292
TN
363A00000X
Physician Assistant
3930
CO
363A00000X
Physician Assistant
Primary
7844
AZ
363AS0400X
Surgical Physician Assistant
2292
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4345332
BLUECROSS BLUESHIELD
TN
01
—
4345333
BLUECROSS BLUESHIELD - PA SURGICAL
TN
01
—
9179985
AETNA
—
01
—
P01222195
RAILROAD MEDICARE
TN
05
—
Q001026
—
TN
Enumeration date
02/01/2013
Last updated
12/02/2022
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