Provider Demographics
NPI:1811027394
Name:HATTON, RANDY C (PHARMD, FCCP, BCPS)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:C
Last Name:HATTON
Suffix:
Gender:M
Credentials:PHARMD, FCCP, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3924 SW 102ND WAY
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-4658
Mailing Address - Country:US
Mailing Address - Phone:352-262-0736
Mailing Address - Fax:352-265-1091
Practice Address - Street 1:3924 SW 102ND WAY
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-4658
Practice Address - Country:US
Practice Address - Phone:352-262-0736
Practice Address - Fax:352-265-1091
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS173171835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy