MEDICARE: DONALD C HYATT

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	12269	AL
2	183500000X	Pharmacist	RPH018207	GA
3	183500000X	Pharmacist	12269	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295054989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD C HYATT

Provider Business Mailing Address
First Line	:	2320 MOORES MILL RD
Second Line	:	SUITE 100
City	:	AUBURN
State	:	AL
Zip	:	36830-8402
Country	:	US
Telephone Number	:	334-887-8780
Fax Number	:	334-887-8786

Provider Business Practice Location Address
First Line	:	2320 MOORES MILL RD
Second Line	:	SUITE 100
City	:	AUBURN
State	:	AL
Zip	:	36830-8402
Country	:	US
Telephone Number	:	334-887-8780
Fax Number	:	334-887-8786

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

Provider Enumeration Date	:	05/20/2010
Last Update Date	:	04/30/2013

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