Individual
DR. ETHAN THOMAS HOERSCHGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1911 S NATIONAL AVE, SUITE 301, SPRINGFIELD, MO 65804-2213
(417) 886-5000
(417) 886-1100
Mailing address
1911 S NATIONAL AVE, SUITE 301, SPRINGFIELD, MO 65804-2213
(417) 886-5000
(417) 886-1100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2004014110
MO
207RN0300X
Nephrology Physician
Primary
2007018015
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447332945
—
MO
Enumeration date
10/20/2006
Last updated
02/10/2011
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