Healthcare Provider Details

I. General information

NPI: 1437174802
Provider Name (Legal Business Name): RAYMOND ERNEST HATTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 08/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 W 24TH ST
YUMA AZ
85364-6123
US

IV. Provider business mailing address

2060 W 24TH ST
YUMA AZ
85364-6123
US

V. Phone/Fax

Practice location:
  • Phone: 928-344-5112
  • Fax: 928-344-5766
Mailing address:
  • Phone: 928-344-5112
  • Fax: 928-344-5766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number23668
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: