Individual
DR. JOHN MICHAEL HATLELID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3009 N BALLAS RD STE 102B, SAINT LOUIS, MO 63131-2343
(314) 996-7080
Mailing address
3009 N BALLAS RD STE 102B, SAINT LOUIS, MO 63131-2343
(314) 996-7080
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
R8615
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130001273
RAILROAD MEDICARE
MO
Enumeration date
02/01/2006
Last updated
02/26/2021
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