Healthcare Provider Details

I. General information

NPI: 1902481815
Provider Name (Legal Business Name): DANIEL HATFIELD PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 HUGHES DR # 220
TOLEDO OH
43606-3858
US

IV. Provider business mailing address

2109 HUGHES DR # 220
TOLEDO OH
43606-3858
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-5150
  • Fax: 419-479-6173
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.006822RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: