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General NPI Number Information
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NPI Number | 1659402006
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Entity Type | Organization
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Legal Business Name | HATCHIE CLINIC P C
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 06/07/2017
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Provider Practice Location Address
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Address Line | 640 NUCKOLLS RD
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City | BOLIVAR
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State | TN
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Zip | 38008-1532
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Country | US
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Telephone | 731-659-2273
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Fax | 731-659-2777
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Provider Business Mailing Address
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Address Line | 640 NUCKOLLS RD PO BOX 331
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City | BOLIVAR
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State | TN
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Zip | 38008-1532
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Country | US
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Telephone | 731-659-2273
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Fax | 731-659-2777
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. LATOSHA S MESSENGER
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Credential |
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Telephone | 731-659-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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