=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245323476
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES J HATCHER MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2006
-----------------------------------------------------
Last Update Date | 12/01/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 840 FIRST COLONIAL RD SUITE 102A
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23451-6106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-491-2466
-----------------------------------------------------
Fax | 757-437-9651
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 840 FIRST COLONIAL RD SUITE 102A
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23451-6106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-491-2466
-----------------------------------------------------
Fax | 757-437-9651
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0200X
-----------------------------------------------------
Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | 0101028885
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | 0101028885
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------