Individual
CHRISTINA M HAWTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
12255 DE PAUL DR, STE 470, BRIDGETON, MO 63044-2510
(314) 739-8863
(314) 739-6448
Mailing address
12255 DE PAUL DR, STE 470, BRIDGETON, MO 63044-2510
(314) 739-8863
(314) 739-6448
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000559
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1984900
CIGNA
MO
01
—
2700497
UHC
MO
05
—
303231500
—
MO
01
—
49331
BLUE CROSS
MO
01
—
CK3051
RR MEDICARE
MO
Enumeration date
10/26/2006
Last updated
12/02/2011
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