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General NPI Number Information
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NPI Number | 1164524187
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Entity Type | Individual
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Provider Name | KARL W HATTLER CCCA
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Gender | Male
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 5400 GIBSON BLVD SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-4729
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Country | US
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Telephone | 505-262-3277
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Fax | 505-262-7216
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Provider Business Mailing Address
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Address Line | 5400 GIBSON BLVD SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-4729
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Country | US
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Telephone | 505-262-7960
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Fax | 505-232-1368
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 075
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License Number State | NM
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