Basic Information
Provider Information
NPI: 1154366110
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAKAS
FirstName: JOSEPH
MiddleName: F
NamePrefix:  
NameSuffix: JR.
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 205 PAGE RD
Address2:  
City: PINEHURST
State: NC
PostalCode: 283748798
CountryCode: US
TelephoneNumber: 9102955511
FaxNumber: 9102353428
Practice Location
Address1: 205 PAGE RD
Address2:  
City: PINEHURST
State: NC
PostalCode: 283748798
CountryCode: US
TelephoneNumber: 9102955511
FaxNumber: 9102353428
Other Information
ProviderEnumerationDate: 06/16/2006
LastUpdateDate: 01/22/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X2002-01472NCY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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