Provider Demographics
NPI:1043486392
Name:HATCHER, KIM LOVAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:LOVAN
Last Name:HATCHER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1066 SOUTHERN WAY
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-3053
Mailing Address - Country:US
Mailing Address - Phone:251-404-5355
Mailing Address - Fax:
Practice Address - Street 1:301 FISHER ST
Practice Address - Street 2:KEESLER AFB
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39534-2508
Practice Address - Country:US
Practice Address - Phone:228-376-3878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS095161835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology