Michael George Hawkinson, CHIROPRACTOR
Individual provider Active NPI Chiropractor · Labadie, MO
NPI 1629253158 · NPPES record last updated Jan 3, 2008
Key facts
- NPI
- 1629253158
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CE0005309 (MO)
- Practice address
- 30 Lake Rd
Labadie, MO 63055-1640 - Phone
- (636) 742-4735
- NPI assigned
- Jan 3, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CE0005309 | MO | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CE0005309 | MO | Yes |
Addresses
Primary practice location
30 Lake Rd
Labadie, MO 63055-1640
Mailing address
30 Lake Rd
Labadie, MO 63055-1640
Phone (636) 742-4735
Other providers in Labadie, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.