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General NPI Number Information
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NPI Number | 1205823887
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Entity Type | Individual
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Provider Name | THOMAS EDWARD HAFER M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 17065 S 71 HIGHWAY
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City | BELTON
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State | MO
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Zip | 64012
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Country | US
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Telephone | 816-348-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 10901 GRANADA LN STE.200
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City | OVERLAND PARK
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State | KS
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Zip | 66211-1401
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Country | US
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Telephone | 913-660-1616
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Fax | 913-660-1664
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 100308
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 04-29021
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License Number State | KS
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