MEDICARE: PATRICK K HITCHCOCK 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	2085R0202X	Diagnostic Radiology Physician	17024	AZ

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	:	1477533776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK K HITCHCOCK MD

Provider Business Mailing Address
First Line	:	500 N US HIGHWAY 89
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86313-5001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 N US HIGHWAY 89
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86313-5001
Country	:	US
Telephone Number	:	928-776-6004
Fax Number	:

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

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	02/22/2010

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Directions to “ PATRICK K HITCHCOCK MD” Practice Location

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