Kathryn Ann Hackman, D.O.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

2004033969 Issued in MO

Practice address

12609 Olive Blvd
Creve Coeur, MO 63141-6313

Phone

(314) 744-8020

Fax

(314) 744-8021

NPI assigned

Apr 30, 2013

Last updated

Apr 30, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1487099842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12609 OLIVE BLVD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416313",
            "telephone_number": "314-744-8020",
            "fax_number": "314-744-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12609 OLIVE BLVD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416313",
            "telephone_number": "314-744-8020",
            "fax_number": "314-744-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKMAN",
        "first_name": "KATHRYN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-30",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2004033969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maram Hamdan, PHARMD.

• General Practice Physician in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• General Practice Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.