Individual
DOMINIC JEFFREY HAERTLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
212 HOSPITAL LN STE 202, PERRYVILLE, MO 63775-4204
(573) 768-3449
(573) 519-5330
Mailing address
212 HOSPITAL LN STE 202, PERRYVILLE, MO 63775-4204
(573) 768-3449
(573) 519-5330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2023016854
MO
208000000X
Pediatrics Physician
2023016854
MO
Other
Enumeration date
03/25/2019
Last updated
09/15/2023
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