Provider Demographics
NPI:1598117442
Name:ABERDEEN, HAZEL (DC)
Entity Type:Individual
Prefix:DR
First Name:HAZEL
Middle Name:
Last Name:ABERDEEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:HAZEL
Other - Middle Name:
Other - Last Name:HARDMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 1911
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-0022
Mailing Address - Country:US
Mailing Address - Phone:901-921-2271
Mailing Address - Fax:
Practice Address - Street 1:1911 MEMPHIS TENNESSEE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119
Practice Address - Country:US
Practice Address - Phone:901-921-2271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-04
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2959111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor