Provider Demographics
NPI:1922264415
Name:HATTON, TWANA J (DO)
Entity Type:Individual
Prefix:
First Name:TWANA
Middle Name:J
Last Name:HATTON
Suffix:
Gender:F
Credentials:DO
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 748
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:KY
Mailing Address - Zip Code:41171-0748
Mailing Address - Country:US
Mailing Address - Phone:606-738-5155
Mailing Address - Fax:606-738-5420
Practice Address - Street 1:390 KY HWY 7 S
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:KY
Practice Address - Zip Code:41171
Practice Address - Country:US
Practice Address - Phone:606-738-5155
Practice Address - Fax:606-738-5420
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03298207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100107470Medicaid
KYP400024571Medicare PIN