Provider Demographics
NPI:1578871802
Name:HATCH, CALEB R (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CALEB
Middle Name:R
Last Name:HATCH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 PEACH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1423
Mailing Address - Country:US
Mailing Address - Phone:814-877-5700
Mailing Address - Fax:814-877-5655
Practice Address - Street 1:100 PEACH ST STE 102
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1423
Practice Address - Country:US
Practice Address - Phone:814-877-5700
Practice Address - Fax:814-877-5655
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA002585363A00000X
PAMA054621363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant