Individual
DR. MATTHEW EARL HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
919 HIGHWAY D, OSAGE BEACH, MO 65065-3169
(573) 348-5963
Mailing address
5105 S BROOKS DR UNIT B, JEFFERSON CITY, MO 65109-0466
(816) 803-0398
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2020020034
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020020034
MISSOURI BOARD OF PHARMACY
MO
Enumeration date
12/03/2020
Last updated
12/03/2020
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