Provider Demographics
NPI:1427284504
Name:HULETT FAMILY PRACTICE, LLC
Entity type:Organization
Organization Name:HULETT FAMILY PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:E
Authorized Official - Last Name:HULETT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:660-646-1435
Mailing Address - Street 1:103 11TH ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601-1676
Mailing Address - Country:US
Mailing Address - Phone:660-646-1435
Mailing Address - Fax:660-646-4643
Practice Address - Street 1:103 11TH ST
Practice Address - Street 2:SUITE 6
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601-1676
Practice Address - Country:US
Practice Address - Phone:660-646-1435
Practice Address - Fax:660-646-4643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1033217906OtherNPI, TYPE 1