Individual
JOHN MALCOLM HUKRIEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1505 E BRADFORD PKWY, SPRINGFIELD, MO 65804-6566
(417) 322-6622
(417) 350-1935
Mailing address
1505 E BRADFORD PKWY STE D, SPRINGFIELD, MO 65804-6566
(417) 660-4469
(417) 350-1935
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2011013290
MO
363A00000X
Physician Assistant
PA-488
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220054154
—
MO
05
—
300293795
—
AR
Enumeration date
06/15/2011
Last updated
12/19/2025
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