Provider Demographics
NPI:1053846105
Name:HATFIELD, NATHAN K (DO)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:K
Last Name:HATFIELD
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:PO BOX 7060
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-7060
Mailing Address - Country:US
Mailing Address - Phone:480-718-1285
Mailing Address - Fax:480-718-1301
Practice Address - Street 1:6820 E BROWN RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-3705
Practice Address - Country:US
Practice Address - Phone:480-718-1285
Practice Address - Fax:480-718-1301
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ390200000X
AZ008505207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program