Provider Demographics
NPI:1275145021
Name:HATFIELD, TOBY KEITH
Entity Type:Individual
Prefix:
First Name:TOBY
Middle Name:KEITH
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 1:2837 BROWNING FRK
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:WV
Mailing Address - Zip Code:25621-3300
Mailing Address - Country:US
Mailing Address - Phone:304-664-3914
Mailing Address - Fax:
Practice Address - Street 1:2837 BROWNING FRK
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:WV
Practice Address - Zip Code:25621-3300
Practice Address - Country:US
Practice Address - Phone:304-664-3914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant