Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Keith J Hacker, PA

Individual provider Physician Assistant · NPI 1952508400

Mr. Keith J Hacker, PA is a Physician Assistant in Port Washington, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2007.

Licensed in
WI
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1777 W Grand Ave
Port Washington, WI 53074-2077
Phone: (262) 284-3456
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 523 (WI)

Record details

NPI number1952508400
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 28, 2007
Last updated in NPPESNovember 23, 2021
Certification dateNovember 23, 2021
Mailing address1777 W Grand Ave, Port Washington, WI 53074-2077

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