Individual
KELLY L HARTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1101 W. LIBERTY, PARKLAND HEALTH CENTER, FARMINGTON, MO 63640
(573) 760-8475
(573) 760-8484
Mailing address
11421 S STATE HIGHWAY 21, POTOSI, MO 63664-3091
(573) 210-6564
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
111596
MO
207Q00000X
Family Medicine Physician
111596
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208854604
—
MO
Enumeration date
02/02/2006
Last updated
04/12/2017
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