Provider Demographics
NPI:1942480405
Name:JOHN W HATCHETT MD PC
Entity Type:Organization
Organization Name:JOHN W HATCHETT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-335-2900
Mailing Address - Street 1:501 E 5TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003-3942
Mailing Address - Country:US
Mailing Address - Phone:918-335-2900
Mailing Address - Fax:918-213-4989
Practice Address - Street 1:501 E 5TH ST STE A
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-3942
Practice Address - Country:US
Practice Address - Phone:918-335-2900
Practice Address - Fax:918-213-4989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13606251G00000X, 314000000X, 315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Single Specialty
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100749310AMedicaid
OK800522039Medicare PIN
OKD39184Medicare UPIN