Provider Demographics
NPI:1073617163
Name:HATFIELD, STEVEN RAY (DPT ATC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:RAY
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:DPT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 GRANT STREET
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315
Mailing Address - Country:US
Mailing Address - Phone:404-622-1783
Mailing Address - Fax:770-271-1822
Practice Address - Street 1:2085 HAMILTON CREEK PKWY
Practice Address - Street 2:SUITE 160
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019
Practice Address - Country:US
Practice Address - Phone:770-271-1488
Practice Address - Fax:770-271-1822
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008143225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA7758698OtherAETNA
GA692612OtherUHC
GA5620514OtherFIRST HEALTH
P32700Medicare UPIN
GA65BBCZZMedicare ID - Type Unspecified