Provider Demographics
NPI:1184666216
Name:HATFIELD, STEPHEN E (DO)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:E
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 1:4850 E BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4625
Mailing Address - Country:US
Mailing Address - Phone:480-461-0047
Mailing Address - Fax:480-461-1103
Practice Address - Street 1:4850 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4625
Practice Address - Country:US
Practice Address - Phone:480-461-0047
Practice Address - Fax:480-461-1103
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2991207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZF69948Medicare UPIN