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NPI Code Detail

MEDICARE: WILLIAM HATCH PA

MEDICARE: WILLIAM HATCH PA
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
1363A00000XPhysician AssistantPA496ID

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00182711OTHERIDRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000010149234OTHERIDBLUE SHIELD
3PATF5OTHERIDBLUE CROSS
4000010149235OTHERIDBLUE SHIELD
5PASU1OTHERIDBLUE CROSS

General Provider Information

NPI Number : 1609865633
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM HATCH PA
Provider Business Mailing Address
First Line : 217 W GEORGIA AVE
Second Line : STE 115
City : NAMPA
State : ID
Zip : 83686-6811
Country : US
Telephone Number : 208-463-3000
Fax Number : 208-463-3034
Provider Business Practice Location Address
First Line : 215 E HAWAII AVE
Second Line :
City : NAMPA
State : ID
Zip : 83686-6011
Country : US
Telephone Number : 208-463-3000
Fax Number : 208-463-3034
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2005
Last Update Date : 07/08/2007

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Directions to “ WILLIAM HATCH PA” Practice Location

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