Provider Demographics
NPI:1457458960
Name:HATCHETT, JAMES MICHAEL (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:HATCHETT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 WYNN DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-4976
Mailing Address - Country:US
Mailing Address - Phone:903-586-6829
Mailing Address - Fax:903-589-3728
Practice Address - Street 1:408 WYNN DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-4976
Practice Address - Country:US
Practice Address - Phone:903-586-6829
Practice Address - Fax:903-589-3728
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12843122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX008274501Medicaid