Individual
DR. RAYMOND ALLEN HACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
140 BRYAN BLVD, CORBIN, KY 40701-2775
(606) 528-1172
(606) 528-7169
Mailing address
PO BOX 1325, CORBIN, KY 40702-1325
(606) 526-8131
(606) 528-8661
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
30657
MN
208800000X
Urology Physician
Primary
45767
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06173HA
BLUE CROSS
—
05
—
084583300
—
MN
01
—
101379C118
UCARE
—
01
—
1900010
MEDICA PRIMARY
—
01
—
1912600
MEDICA
—
01
—
340004898
RAILROAD MEDICARE
MN
05
—
34603700
—
WI
05
—
7100228250
—
KY
01
—
961240267002
PREFERRED ONE
—
01
—
A06082
WAUSAU
—
01
—
HP13441
HEALTHPARTNERS
—
01
—
P01427472
RR MEDICARE
KY
Enumeration date
08/20/2006
Last updated
12/03/2020
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