Provider Demographics
NPI:1508980657
Name:HEWITT, THOMAS CHAD (DPM)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CHAD
Last Name:HEWITT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6717 N OAK TRFY
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118-3346
Mailing Address - Country:US
Mailing Address - Phone:816-452-1211
Mailing Address - Fax:816-452-4211
Practice Address - Street 1:6717 N OAK TRFY
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-3346
Practice Address - Country:US
Practice Address - Phone:816-452-1211
Practice Address - Fax:816-452-4211
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3298213ES0103X
MO2007021183213ES0131X
KS12-00456213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery