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Individual

DR. BILL JUNIOR HACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
305 ESTILL ST FL 4, BEREA, KY 40403-1909
(859) 986-2343
(859) 986-2344
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7835
(859) 986-2344

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
52643
KY
207R00000X
Internal Medicine Physician
Primary
R4084
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100501920
KY
Enumeration date
04/20/2016
Last updated
04/23/2026
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