Healthcare Provider Details

I. General information

NPI: 1295054989
Provider Name (Legal Business Name): DONALD C HYATT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2010
Last Update Date: 04/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 MOORES MILL RD SUITE 100
AUBURN AL
36830-8402
US

IV. Provider business mailing address

2320 MOORES MILL RD SUITE 100
AUBURN AL
36830-8402
US

V. Phone/Fax

Practice location:
  • Phone: 334-887-8780
  • Fax: 334-887-8786
Mailing address:
  • Phone: 334-887-8780
  • Fax: 334-887-8786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH018207
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12269
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number12269
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: