Provider Demographics
NPI:1346229796
Name:HATFIELD, PATRICK M (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:M
Last Name:HATFIELD
Suffix:
Gender:M
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:PO BOX 2276
Mailing Address - Street 2:299 EAGLE MOUNTAIN BLVD
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72503-2276
Mailing Address - Country:US
Mailing Address - Phone:870-698-9100
Mailing Address - Fax:870-698-0161
Practice Address - Street 1:299 EAGLE MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72503-2276
Practice Address - Country:US
Practice Address - Phone:870-698-9100
Practice Address - Fax:870-698-0161
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE0184207N00000X, 207ND0900X, 207ND0101X, 207NS0135X, 207NI0002X, 207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G00103Medicare UPIN
AR5J656Medicare ID - Type Unspecified