Individual
WALTER HARGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2550 LUSK DR, NEOSHO, MO 64850-8855
(417) 451-2060
(417) 451-6214
Mailing address
2550 LUSK DR, NEOSHO, MO 64850-8855
(417) 451-2060
(417) 451-6214
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R4D90
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200207220A
—
OK
05
—
203466727
—
MO
Enumeration date
06/10/2006
Last updated
03/17/2016
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