Provider Demographics
NPI:1104826163
Name:HATFIELD, ROBERT W (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:R.
Other - Middle Name:WAYNE
Other - Last Name:HATFIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2001 LAUREL AVE
Mailing Address - Street 2:SUITE 502
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1810
Mailing Address - Country:US
Mailing Address - Phone:865-331-9000
Mailing Address - Fax:865-331-7000
Practice Address - Street 1:2001 LAUREL AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1810
Practice Address - Country:US
Practice Address - Phone:865-331-9000
Practice Address - Fax:865-331-7000
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000028878208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1669416442OtherGROUP NPI
TN3106057OtherBLUE CROSS
TNCI2260OtherRAILROAD MEDICARE
TN3883459Medicaid
TN020252399OtherEEOICP
TN4063095OtherBLUE CROSS
TNH82948Medicare UPIN
TN4063095OtherBLUE CROSS
1260440003Medicare NSC
TN3106057OtherBLUE CROSS
TN3714753Medicare PIN