Healthcare Provider Details

I. General information

NPI: 1073934568
Provider Name (Legal Business Name): BRIT SUMNER HATCH PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2013
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N COUNTRY CLUB DR STE 6
MESA AZ
85201-2537
US

IV. Provider business mailing address

1150 N COUNTRY CLUB DR STE 6
MESA AZ
85201-2537
US

V. Phone/Fax

Practice location:
  • Phone: 480-962-1050
  • Fax: 480-962-1058
Mailing address:
  • Phone: 480-962-1050
  • Fax: 480-962-1058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5616
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: