Provider Demographics
NPI:1922015239
Name:HATCH, KALA R (NP)
Entity type:Individual
Prefix:DR
First Name:KALA
Middle Name:R
Last Name:HATCH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:DR
Other - First Name:KALA
Other - Middle Name:R
Other - Last Name:HATCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6161 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1902
Practice Address - Country:US
Practice Address - Phone:918-502-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK115172363LF0000X
AR1524111N00000X
OKMO115172363LA2100X
ARR089609363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR139112718Medicaid
AR350046599OtherMEDICARE RAILROAD
AR5U393OtherBLUE CROSS/BLUE SHIELD
AR139112718Medicaid
ARU75863Medicare UPIN