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General NPI Number Information
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NPI Number | 1073509519
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Entity Type | Individual
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Provider Name | ANDREW PHILLIP HYATT DO
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 05/06/2011
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Provider Practice Location Address
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Address Line | SA-1 RM L201 2401 E STREET NW
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City | WASHINGTON
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State | DC
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Zip | 20520-0001
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Country | US
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Telephone | 801-615-5530
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Fax |
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Provider Business Mailing Address
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Address Line | 145 N 170 E
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City | OREM
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State | UT
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Zip | 84057-5527
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Country | US
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Telephone | 801-615-5530
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0102202598
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License Number State | VA
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