Provider Demographics
NPI:1851420434
Name:HADEL, DOUGLAS V (DC)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:V
Last Name:HADEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5304 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207-3204
Mailing Address - Country:US
Mailing Address - Phone:913-649-3300
Mailing Address - Fax:
Practice Address - Street 1:5304 W 95TH ST
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66207-3204
Practice Address - Country:US
Practice Address - Phone:913-649-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03458111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0004558Medicare ID - Type Unspecified