Individual
BRANT NICHOLAS HACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 2ND AVE, MADISON, MN 56256-1006
(320) 598-7551
(320) 598-3798
Mailing address
900 2ND AVE, MADISON, MN 56256-1006
(320) 598-7551
(320) 598-3798
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46741
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
508995600
—
MN
Enumeration date
12/11/2006
Last updated
08/16/2017
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