Individual
MARK HACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
1320 WEST MAIN ST, NEWARK, OH 43055
(220) 564-4151
(220) 564-7153
Mailing address
1320 WEST MAIN ST, NEWARK, OH 43055
(220) 564-4151
(220) 564-7153
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.002469
OH
363A00000X
Physician Assistant
50002469RX
OH
363AM0700X
Medical Physician Assistant
53306
CA
Other
Enumeration date
09/22/2006
Last updated
03/24/2023
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