Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | E0963 | AR |
NPI | 1114919107 |
---|---|
Provider Name | Dr. Allan B Hatch |
First Address | Benton, AR 72019-2351 |
Second Address | Benton, AR 72019-2351 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 06/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1104959410 | GROUP - NPI (01) | AR |
129524001 | (05) | AR |
F42666 | (02) |