Healthcare Provider Details

I. General information

NPI: 1821150855
Provider Name (Legal Business Name): HATFIELD PHYSICIAN SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 10/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CARAWAY DR SUITE 1
WINFIELD AL
35594-5048
US

IV. Provider business mailing address

PO BOX 1857
WINFIELD AL
35594-1419
US

V. Phone/Fax

Practice location:
  • Phone: 205-487-3625
  • Fax: 205-487-7559
Mailing address:
  • Phone: 205-487-3625
  • Fax: 205-487-7559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO-649
License Number StateAL

VIII. Authorized Official

Name: DR. ERIC JASON HATFIELD
Title or Position: PRESIDENT
Credential: D.O.
Phone: 205-487-3625