Provider Demographics
NPI:1528389517
Name:HYATT, DUSTIN CRAIG (MD)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:CRAIG
Last Name:HYATT
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10005
Mailing Address - Street 2:ECM HEALTH GROUP, LLC
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35631-2005
Mailing Address - Country:US
Mailing Address - Phone:256-766-6026
Mailing Address - Fax:256-766-6345
Practice Address - Street 1:541 W. COLLEGE STREET
Practice Address - Street 2:SUITE 3300
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630
Practice Address - Country:US
Practice Address - Phone:256-766-6026
Practice Address - Fax:256-766-6345
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2015-06-30
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Provider Licenses
StateLicense IDTaxonomies
OK27819208600000X
AL34232208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No208600000XAllopathic & Osteopathic PhysiciansSurgery