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Individual

MICHAEL L HEARNDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
444 FOUR STATES DR, SUITE 1, GALENA, KS 66739-4324
(620) 783-4441
(620) 783-4090
Mailing address
PO BOX 2546, JOPLIN, MO 64803-2546
(620) 783-4441
(620) 783-4090

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
062351
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
534506
KS
208VP0014X
Interventional Pain Medicine Physician
5654
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200300250A
OK
Enumeration date
04/04/2007
Last updated
04/07/2015
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