Provider Demographics
NPI:1114960622
Name:HATCHER, STEPHANIE ALISON (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ALISON
Last Name:HATCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THREE MARYLAND FARM, SUITE 250
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5053
Mailing Address - Country:US
Mailing Address - Phone:615-373-7600
Mailing Address - Fax:866-653-0021
Practice Address - Street 1:111 HIGHWAY 70 E
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2080
Practice Address - Country:US
Practice Address - Phone:615-326-2443
Practice Address - Fax:615-326-2440
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000031023208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNPENDINGMedicaid
TN3869400Medicare ID - Type Unspecified
H51938Medicare UPIN