=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801873021
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RONALD S HATTIN M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/29/2005
-----------------------------------------------------
Last Update Date | 04/18/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 455 SHERMAN SUITE 510
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80203-4405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-377-6825
-----------------------------------------------------
Fax | 303-780-0787
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 455 SHERMAN ST STE 510
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80203-4400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-377-6825
-----------------------------------------------------
Fax | 303-780-0787
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 26505
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207LP2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Anesthesiology) Physician
-----------------------------------------------------
License Number | 26505
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------