MEDICARE: DR. ELAINE W 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	208000000X	Pediatrics Physician	20268	TN

General Provider Information

NPI Number	:	1275518011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELAINE W HATCH MD

Provider Business Mailing Address
First Line	:	1303 TAFT HWY
Second Line	:
City	:	SIGNAL MOUNTAIN
State	:	TN
Zip	:	37377-3207
Country	:	US
Telephone Number	:	423-886-7529
Fax Number	:	423-886-1194

Provider Business Practice Location Address
First Line	:	1303 TAFT HWY
Second Line	:
City	:	SIGNAL MOUNTAIN
State	:	TN
Zip	:	37377-3207
Country	:	US
Telephone Number	:	423-886-7529
Fax Number	:	423-886-1194

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

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	08/13/2008

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