Provider Demographics
NPI:1588861637
Name:R. G. HATTEN, D. C., P.C.
Entity type:Organization
Organization Name:R. G. HATTEN, D. C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZATION OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:660-679-4431
Mailing Address - Street 1:30 N DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:MO
Mailing Address - Zip Code:64730-2027
Mailing Address - Country:US
Mailing Address - Phone:660-679-4431
Mailing Address - Fax:660-679-3373
Practice Address - Street 1:30 N DELAWARE ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:MO
Practice Address - Zip Code:64730-2027
Practice Address - Country:US
Practice Address - Phone:660-679-4431
Practice Address - Fax:660-679-3373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO4035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0003601Medicare ID - Type Unspecified
MO0002746Medicare ID - Type Unspecified