Individual
HIATT T WOLFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
800 PIKE ST STE 2, EXPRESS CARE - MARIETTA, MARIETTA, OH 45750-3507
(740) 373-3960
(740) 373-3965
Mailing address
401 MATTHEW ST, EMERGENCY DEPARTMENT, MARIETTA, OH 45750
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
010956
NY
363AM0700X
Medical Physician Assistant
01281
WV
363AM0700X
Medical Physician Assistant
Primary
50.003091RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0084465
—
OH
Enumeration date
02/27/2007
Last updated
01/20/2021
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