David Reed Hadlock, D.O.

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

O-163 Issued in ID

Practice address

496 C Shoup Ave W
Twin Falls, ID 83301-4563

Phone

(208) 735-0000

Fax

(208) 734-1717

NPI assigned

Mar 14, 2007

Last updated

Feb 6, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1629101928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 C SHOUP AVE W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014563",
            "telephone_number": "208-735-0000",
            "fax_number": "208-734-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 C SHOUP AVE W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014563",
            "telephone_number": "208-735-0000",
            "fax_number": "208-734-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADLOCK",
        "first_name": "DAVID",
        "middle_name": "REED",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "ID",
            "license": "O-163",
            "primary": true
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "ID",
            "license": "O-163",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "ID",
            "license": "0-163",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004312000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myron D. Guymon, D.D.S., M.S. PC
• Paul David Guymon, LMSW
• Elya Gyurdzhiyants
• Breana Haag, OTR/L
• Michella Ann Habeck, CNM
• Cody Hafer
• Anita Rose Haight, CNA
• Audra Hairston
• Amy Hale, PT, DPT
• Joshua E Hall, M.D.

• Addiction Medicine (Family Medicine) Physician in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Addiction Medicine (Family Medicine) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.