# VAL VISTA LAKES FAMILY MEDICINE, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487605481
- **Authorized official:** DR. KENT HATFIELD DO (PRESIDENT/CEO)
- **Authorized official phone:** (480) 545-1100

## Contact information

- **Practice address:** 3331 E BASELINE RD, GILBERT, AZ 85234-2633
- **Practice address phone:** (480) 545-1100
- **Practice address fax:** (480) 545-7181
- **Mailing address:** 3331 E BASELINE RD, GILBERT, AZ 85234-2633
- **Mailing address phone:** (480) 545-1100
- **Mailing address fax:** (480) 545-7181

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/14/2006
- **Last updated:** 07/11/2007