Individual
ANDREW B HYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1854 BROADWAY ST, CAPE GIRARDEAU, MO 63701-4553
(573) 381-5050
(573) 519-6050
Mailing address
1854 BROADWAY ST, CAPE GIRARDEAU, MO 63701-4553
(573) 381-5050
(573) 519-6050
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2006012804
MO
207Q00000X
Family Medicine Physician
2006012804
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204905905
—
MO
01
—
962601701
MEDICARE GROUP PIN (LA)
MO
01
—
962602300
MEDICARE GROUP PIN (BG)
MO
Enumeration date
04/10/2006
Last updated
02/02/2025
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