Theobald-Hazel, Kristen Anne
Theobald-Hazel, Kristen Anne is an individual health care provider with primary practice located at 1057 Medical Park Dr , Osage Beach MO 65065-3000. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Theobald-Hazel, Kristen Anne can be contacted via phone (573) 302-3100.Contact Information
Primary practice address
1057 Medical Park Dr
Osage Beach MO 65065-3000
Phone: (573) 302-3100
Fax: (573) 348-8279
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2009001633 | Missouri |
Profile Details
| NPI number | 1932201837 |
|---|---|
| LBN Legal business name | Theobald-Hazel, Kristen Anne |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 1st, 2006 |
| Last updated | Sep 2nd, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932201837 | NPPES |
| Missouri | MEDICAID | 1447229489 |
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