MEDICARE: DR. ALLAN B HATCH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	E0963	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1104959410	OTHER	AR	GROUP - NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114919107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLAN B HATCH MD

Provider Business Mailing Address
First Line	:	1000 HIGHWAY 35 N STE 8
Second Line	:	P.O. BOX 2860
City	:	BENTON
State	:	AR
Zip	:	72019-2351
Country	:	US
Telephone Number	:	501-315-4008
Fax Number	:	501-315-3411

Provider Business Practice Location Address
First Line	:	1000 HIGHWAY 35 N
Second Line	:	SUITE 8
City	:	BENTON
State	:	AR
Zip	:	72019-2351
Country	:	US
Telephone Number	:	501-315-4008
Fax Number	:	501-315-3411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	09/06/2016

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