Provider Demographics
NPI:1922243682
Name:HARGETT, CHRISTOPHER DWAIN (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DWAIN
Last Name:HARGETT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-3000
Mailing Address - Country:US
Mailing Address - Phone:334-790-4477
Mailing Address - Fax:334-699-4473
Practice Address - Street 1:1812 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3000
Practice Address - Country:US
Practice Address - Phone:334-790-4477
Practice Address - Fax:334-699-4473
Is Sole Proprietor?:No
Enumeration Date:2008-12-10
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125050490207T00000X
ALDO1190207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery