Provider Demographics
NPI:1821274630
Name:DAVID HADDEN, LLC
Entity Type:Organization
Organization Name:DAVID HADDEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-795-7082
Mailing Address - Street 1:2960 HIGHWAY K
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-7861
Mailing Address - Country:US
Mailing Address - Phone:636-272-7473
Mailing Address - Fax:636-272-8472
Practice Address - Street 1:2960 HIGHWAY K
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-7861
Practice Address - Country:US
Practice Address - Phone:636-272-7473
Practice Address - Fax:636-272-8472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005000656111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000015558OtherMEDICARE PTAN