Provider Demographics
NPI:1356438154
Name:HATFIELD, ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11876 OLIO RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9765
Mailing Address - Country:US
Mailing Address - Phone:317-595-9620
Mailing Address - Fax:317-595-9630
Practice Address - Street 1:11876 OLIO RD
Practice Address - Street 2:SUITE 500
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9765
Practice Address - Country:US
Practice Address - Phone:317-595-9620
Practice Address - Fax:317-595-9630
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002290A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor