Provider Demographics
NPI:1316048309
Name:HATFIELD, KEVIN DEAN (DC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:DEAN
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 S CAMPBELL AVE STE E
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-4912
Mailing Address - Country:US
Mailing Address - Phone:417-886-9355
Mailing Address - Fax:417-886-9366
Practice Address - Street 1:3213 S CAMPBELL AVE STE E
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-4912
Practice Address - Country:US
Practice Address - Phone:417-886-9355
Practice Address - Fax:417-886-9366
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO6804111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO469849OtherHEALTHLINK ID #
MO142992OtherBLUE CROSS/ BL SHILD ID #
MO664453OtherACN & UNITED HEALTHCARE
MOU77094Medicare UPIN