Provider Demographics
NPI:1437180809
Name:HATCH, ANDREW MARSHALL JR (PT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:MARSHALL
Last Name:HATCH
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 DEKALB PLAZA BLVD SW
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35967-4868
Mailing Address - Country:US
Mailing Address - Phone:256-997-9991
Mailing Address - Fax:256-997-9950
Practice Address - Street 1:1102 DEKALB PLAZA BLVD SW
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35967-4868
Practice Address - Country:US
Practice Address - Phone:256-997-9991
Practice Address - Fax:256-997-9950
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3406225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
26-0468379OtherTID
51596286OtherBCBS
AL1013114065OtherNPI ORGANIZATION NUMBER
1437180809OtherNPI
510I650207OtherMEDICARE PTAN
ALPTH3406OtherPHYSICAL THERAPY
AL51048428OtherBCBS