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Individual

ANDREW MARSHALL HATCH JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1102 DEKALB PLAZA BLVD SW, FORT PAYNE, AL 35967-4868
(256) 997-9991
(256) 997-9950
Mailing address
1102 DEKALB PLAZA BLVD SW, FORT PAYNE, AL 35967-4868
(256) 997-9991
(256) 997-9950

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH3406
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013114065
NPI ORGANIZATION NUMBER
AL
01
1437180809
NPI
01
26-0468379
TID
01
51048428
BCBS
AL
01
510I650207
MEDICARE PTAN
01
51596286
BCBS
01
PTH3406
PHYSICAL THERAPY
AL
Enumeration date
07/05/2006
Last updated
09/23/2011
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