Provider Demographics
NPI:1467696021
Name:PATRICK HATFIELD, M.D., P.A.
Entity Type:Organization
Organization Name:PATRICK HATFIELD, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:M
Authorized Official - Last Name:HATFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-698-9100
Mailing Address - Street 1:299 EAGLE MOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-4232
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:72501-4232
Practice Address - Country:US
Practice Address - Phone:870-698-9100
Practice Address - Fax:870-698-0161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE0184207N00000X, 207ND0101X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR128475001Medicaid
ARG00103Medicare UPIN
AR128475001Medicaid