Provider Demographics
NPI:1689199200
Name:HATTON, ADRIAN T
Entity Type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:T
Last Name:HATTON
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:ADRIAN
Other - Middle Name:
Other - Last Name:HATTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2817 BUILD AMERICA DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3226
Mailing Address - Country:US
Mailing Address - Phone:757-826-0600
Mailing Address - Fax:
Practice Address - Street 1:2817 BUILD AMERICA DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3226
Practice Address - Country:US
Practice Address - Phone:757-826-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-1766251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA81-4762638Medicaid