Provider Demographics
NPI:1457766792
Name:HATCH, ANNE MARIE (DO)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:HATCH
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 1:5090 N 40TH ST STE 250A
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2134
Mailing Address - Country:US
Mailing Address - Phone:602-258-3354
Mailing Address - Fax:602-258-3368
Practice Address - Street 1:5090 N 40TH ST STE 250A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018
Practice Address - Country:US
Practice Address - Phone:602-258-3354
Practice Address - Fax:602-258-3368
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR24362084N0400X
AZ0079652084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty