Provider Demographics
NPI:1780860551
Name:HATCHETT-BRIGHT, TIFFANY
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:HATCHETT-BRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:HATCHETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:202 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-4627
Mailing Address - Country:US
Mailing Address - Phone:501-835-7429
Mailing Address - Fax:501-833-0028
Practice Address - Street 1:202 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-4627
Practice Address - Country:US
Practice Address - Phone:501-835-7429
Practice Address - Fax:501-833-0028
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2551152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR180848722Medicaid
AR5G262Medicare PIN