Provider Demographics
NPI:1841297413
Name:SETTLEMOIR, HYET LESLIE (DO)
Entity type:Individual
Prefix:DR
First Name:HYET
Middle Name:LESLIE
Last Name:SETTLEMOIR
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 1:320 E HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-2704
Mailing Address - Country:US
Mailing Address - Phone:618-624-3368
Mailing Address - Fax:618-624-3387
Practice Address - Street 1:705 S GRAND ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:IL
Practice Address - Zip Code:62263
Practice Address - Country:US
Practice Address - Phone:618-327-8236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036111208207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036111208Medicaid
IL08232205OtherBLUE CROSS BLUE SHIELD
IL08232204OtherBLUE CROSS BLUE SHIELD
IL06032182OtherBLUE CROSS BLUE SHIELD
ILI17824Medicare UPIN
IL036111208Medicaid
ILK41383Medicare PIN
ILK37122Medicare PIN
IL08232205OtherBLUE CROSS BLUE SHIELD