Healthcare Provider Details

I. General information

NPI: 1972792174
Provider Name (Legal Business Name): DANIEL ROBERT HATCHER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF THE AIR FORCE, 86 MDG OPC 02 BOX 60
APO AE
09094
US

IV. Provider business mailing address

DEPARTMENT OF THE AIR FORCE, 86 MDG OPC 02 BOX 60
APO AE
09094-9001
US

V. Phone/Fax

Practice location:
  • Phone: 314-479-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberDR46071
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberDR-46071
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR46071
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: