Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 101381 | MO |
NPI | 1306949300 |
---|---|
Provider Name | Mark Lewis Hechler |
First Address | Warrensburg, MO 64093-7572 |
Second Address | Warrensburg, MO 64093-9303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 12/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F30592 | (02) | MO |