Healthcare Provider Details

I. General information

NPI: 1750487922
Provider Name (Legal Business Name): ROBERT HATCHITT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 NW 114TH ST STE 255
CLIVE IA
50325-7036
US

IV. Provider business mailing address

PO BOX 674721
DALLAS TX
75267-4721
US

V. Phone/Fax

Practice location:
  • Phone: 515-461-9780
  • Fax: 515-461-9779
Mailing address:
  • Phone: 515-643-2519
  • Fax: 515-461-9779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number3054
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3054
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO-03054
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: