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Individual

DR. ELTON W. HOERNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1905 W 19TH ST, MOUNTAIN GROVE, MO 65711-1287
(417) 926-1770
(417) 926-1785
Mailing address
PO BOX 702, MOUNTAIN GROVE, MO 65711-0702
(417) 926-2028

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R5P96
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
206659112
MO
01
26D2006074
CLIA
MO
Enumeration date
11/20/2006
Last updated
11/20/2019
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