Individual
DR. ROGER LEW HIATT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 N 7TH ST, WEST MEMPHIS, AR 72301-3235
(870) 394-7100
(870) 394-7111
Mailing address
10047 BUSHROD CV, COLLIERVILLE, TN 38017-9188
(801) 200-5050
(870) 394-7111
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
N-8381
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130272001
—
AR
Enumeration date
02/23/2007
Last updated
12/23/2019
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