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General NPI Number Information
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NPI Number | 1427284504
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Entity Type | Organization
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Legal Business Name | HULETT FAMILY PRACTICE, LLC
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Dates
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Enumeration Date | 06/03/2009
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Last Update Date | 07/29/2009
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Provider Practice Location Address
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Address Line | 103 11TH ST SUITE 6
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City | CHILLICOTHEE
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State | MO
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Zip | 64601-1676
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Country | US
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Telephone | 660-646-1435
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Fax | 660-646-4643
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Provider Business Mailing Address
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Address Line | 103 11TH ST SUITE 6
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City | CHILLICOTHEE
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State | MO
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Zip | 64601-1676
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Country | US
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Telephone | 660-646-1435
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Fax | 660-646-4643
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CHRISTOPHER E HULETT
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Credential | D.O.
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Telephone | 660-646-1435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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