Provider Demographics
NPI:1750642724
Name:HATFIELD, STEPHEN K (BHRS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:K
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:RINGLING
Mailing Address - State:OK
Mailing Address - Zip Code:73456-0066
Mailing Address - Country:US
Mailing Address - Phone:918-623-6552
Mailing Address - Fax:
Practice Address - Street 1:32 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-7013
Practice Address - Country:US
Practice Address - Phone:918-623-6552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100708380AMedicaid