Provider Demographics
NPI:1366503930
Name:HATCHETT, JOHN W (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:HATCHETT
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 1:3400 SE FRANK PHILLIPS BLV
Mailing Address - Street 2:SUITE 700
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-2443
Mailing Address - Country:US
Mailing Address - Phone:918-335-2900
Mailing Address - Fax:918-331-2449
Practice Address - Street 1:3400 SE FRANK PHILLIPS BLV
Practice Address - Street 2:SUITE 700
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2443
Practice Address - Country:US
Practice Address - Phone:918-335-2900
Practice Address - Fax:918-331-2449
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13606174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD39184Medicare UPIN