Provider Demographics
NPI:1598413684
Name:HATCHER-FAGAN, JEFFERY II (MSOT, OTR/L, OTD)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:
Last Name:HATCHER-FAGAN
Suffix:II
Gender:M
Credentials:MSOT, OTR/L, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2085 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MOODY
Mailing Address - State:AL
Mailing Address - Zip Code:35004-3250
Mailing Address - Country:US
Mailing Address - Phone:205-937-3905
Mailing Address - Fax:
Practice Address - Street 1:600 19TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-934-3201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4171225XL0004X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision