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NPI Code Detail

MEDICARE: JESSE HATFIELD

MEDICARE:   JESSE  HATFIELD
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
1207P00000XEmergency Medicine PhysicianE-9425AR

General Provider Information

NPI Number : 1275822298
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE HATFIELD
Provider Business Mailing Address
First Line : 4801 NASSAU CIR
Second Line :
City : SAND SPRINGS
State : OK
Zip : 74063-2125
Country : US
Telephone Number : 918-960-4504
Fax Number :
Provider Business Practice Location Address
First Line : 4502 E 41ST ST
Second Line :
City : TULSA
State : OK
Zip : 74135-2536
Country : US
Telephone Number : 919-660-3823
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2011
Last Update Date : 10/07/2015

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Directions to “ JESSE HATFIELD ” Practice Location

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