Healthcare Provider Details

I. General information

NPI: 1427284504
Provider Name (Legal Business Name): HULETT FAMILY PRACTICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2009
Last Update Date: 07/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 11TH ST SUITE 6
CHILLICOTHEE MO
64601-1676
US

IV. Provider business mailing address

103 11TH ST SUITE 6
CHILLICOTHEE MO
64601-1676
US

V. Phone/Fax

Practice location:
  • Phone: 660-646-1435
  • Fax: 660-646-4643
Mailing address:
  • Phone: 660-646-1435
  • Fax: 660-646-4643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER E HULETT
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 660-646-1435