MEDICARE: STEPHEN H HAZEN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NN1001X	Nutrition Chiropractor	783	NM

General Provider Information

NPI Number	:	1194716852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN H HAZEN D.C.

Provider Business Mailing Address
First Line	:	2932 S RICHARDS AVE
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87507-5986
Country	:	US
Telephone Number	:	505-473-0000
Fax Number	:	505-473-5315

Provider Business Practice Location Address
First Line	:	2932 S RICHARDS AVE
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87507-5986
Country	:	US
Telephone Number	:	505-473-0000
Fax Number	:	505-473-5315

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	07/08/2007

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Directions to “ STEPHEN H HAZEN D.C.” Practice Location

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