Healthcare Provider Details
I. General information
NPI: 1467696021
Provider Name (Legal Business Name): PATRICK HATFIELD, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/27/2009
Last Update Date: 10/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
299 EAGLE MOUNTAIN BLVD
BATESVILLE AR
72501-4232
US
IV. Provider business mailing address
299 EAGLE MOUNTAIN BLVD
BATESVILLE AR
72501-4232
US
V. Phone/Fax
- Phone: 870-698-9100
- Fax: 870-698-0161
- Phone: 870-698-9100
- Fax: 870-698-0161
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | E0184 |
| License Number State | AR |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ND0900X |
| Taxonomy | Dermatopathology Physician |
| License Number | E0184 |
| License Number State | AR |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ND0101X |
| Taxonomy | MOHS-Micrographic Surgery Physician |
| License Number | E0184 |
| License Number State | AR |
VIII. Authorized Official
Name:
PATRICK
M
HATFIELD
Title or Position: OWNER
Credential: M.D.
Phone: 870-698-9100