Individual
JEFFREY HACKWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
315 S OSTEOPATHY AVE, KIRKSVILLE, MO 63501-6401
(660) 785-1000
Mailing address
602 W LINK ST, KIRKSVILLE, MO 63501-4342
(909) 374-7466
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2018022479
MO
207R00000X
Internal Medicine Physician
Primary
T8554
TX
208D00000X
General Practice Physician
2019036773
MO
Other
Enumeration date
06/30/2018
Last updated
02/23/2023
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