DR. HAWKINS BOONE MECHAM


Address: 407 S Main St # 2, Kirksville, MO 63501
Phone: 8018364621

DR. HAWKINS BOONE MECHAM (NPI# 1285080796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1285080796
Entity Type Individual
Full Name DR. HAWKINS BOONE MECHAM
Credential D.O.
Practice Address 407 S Main St # 2
Kirksville
MO 63501
Mailing Address 407 S Main St # 2
Kirksville
MO 63501-3424
Practice Telephone 8018364621
Enumeration Date 2016-05-13
Last Update Date 2019-07-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208D00000X General Practice DO187716 OR Allopathic & Osteopathic Physicians
N 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Provider Secondary Practice Location

Address Telephone Number Fax Number
521 East Ave, Lockport, NY 140943201 7165141233 7165145549

Office Location

Street Address 407 S MAIN ST # 2
City KIRKSVILLE
State MO
Zip Code 63501

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1902302912 Brittney Frances Snelling Specialist/Technologist 26820 State Hwy 11, Kirksville, MO 63501 2018-03-30
1063931434 Kara Wehmeyer Specialist/Technologist 100 East Normal, Kirksville, MO 63501 2017-09-16
1003287848 Lacosta Gaines Nurse Practitioner 1607 South Baltimore, Kirksville, MO 63501 2015-10-19
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1497069694 Ella Marie Callison Physician Assistant 1611 S Baltimore St Ste A, Kirksville, MO 63501 2010-07-29
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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

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1912462912 Thomas George Brett General Practice 800 Missouri 248, Building 3 Suite A, Branson, MO 65616 2019-02-04
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1821579798 Healthy Schools Missouri LLC General Practice 3675 S Noland Rd Ste 200, Independence, MO 64055-3369 2018-08-28
1902300825 Landmark Medical of Missouri PC General Practice 312 Sw Greenwich Dr # 315, Lees Summit, MO 64082-4408 2018-03-23
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1093218224 Andrew Jason Doppelt General Practice 200 E Southampton Dr Ste 104, Columbia, MO 65203-3032 2018-03-14
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Competitor

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City KIRKSVILLE
Zip Code 63501

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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