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NPI Code Detail

MEDICARE: DR. PAUL HIATT PSY.D.

MEDICARE:  DR. PAUL  HIATT  PSY.D.
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
1103TC0700XClinical PsychologistPS017833PA

General Provider Information

NPI Number : 1437543477
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL HIATT PSY.D.
Provider Business Mailing Address
First Line : 554E HEWSON ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19125-2435
Country : US
Telephone Number : 267-571-9643
Fax Number : 866-424-5162
Provider Business Practice Location Address
First Line : 1420 WALNUT ST 1206
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19102-4012
Country : US
Telephone Number : 267-571-9643
Fax Number : 866-424-5162
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2015
Last Update Date : 10/12/2015

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Directions to “ DR. PAUL HIATT PSY.D.” Practice Location

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