Individual
DAVID K HAGEDORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3315 MCINTOSH CIR, JOPLIN, MO 64804-3649
(417) 347-4800
(417) 347-4033
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-4800
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2002019238
MO
207Q00000X
Family Medicine Physician
2002019238
MO
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
2002019238
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100424830D
—
KS
05
—
100846000A
—
OK
05
—
208358606
—
MO
Enumeration date
06/13/2006
Last updated
03/28/2016
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