Provider Demographics
NPI:1811984917
Name:HATCH, DANIEL J (DPM)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:HATCH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 65TH AVE
Mailing Address - Street 2:STE A
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-7946
Mailing Address - Country:US
Mailing Address - Phone:970-351-0900
Mailing Address - Fax:970-351-0940
Practice Address - Street 1:1931 65TH AVE
Practice Address - Street 2:STE A
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-7946
Practice Address - Country:US
Practice Address - Phone:970-351-0900
Practice Address - Fax:970-351-0940
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO327213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01003276Medicaid
COCA0413Medicare PIN
T60326Medicare UPIN