Provider Demographics
NPI:1225702608
Name:HATFIELD, CHARLES W
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:W
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 611
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MO
Mailing Address - Zip Code:64085-0611
Mailing Address - Country:US
Mailing Address - Phone:816-776-5678
Mailing Address - Fax:816-776-3979
Practice Address - Street 1:39547 BUSINESS HIGHWAY 10
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MO
Practice Address - Zip Code:64085-8354
Practice Address - Country:US
Practice Address - Phone:816-776-5678
Practice Address - Fax:816-776-3979
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020043233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor