Healthcare Provider Details

I. General information

NPI: 1598092702
Provider Name (Legal Business Name): JOHN MICHAEL HATFIELD DO, DC, MPH, MOH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2009
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 MDG 4881 SUGAR MAPLE DR.
WRIGHT-PATTERSON AFB OH
45433-5529
US

IV. Provider business mailing address

88 MDG 4881 SUGAR MAPLE DR.
WRIGHT-PATTERSON AFB OH
45433-5529
US

V. Phone/Fax

Practice location:
  • Phone: 937-938-3718
  • Fax:
Mailing address:
  • Phone: 937-938-3718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number701
License Number StateNE

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: