Organization
VAL VISTA LAKES FAMILY MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENT HATFIELD DO (PRESIDENT/CEO)
(480) 545-1100
Entity
Organization
Contact information
Practice address
3331 E BASELINE RD, GILBERT, AZ 85234-2633
(480) 545-1100
(480) 545-7181
Mailing address
3331 E BASELINE RD, GILBERT, AZ 85234-2633
(480) 545-1100
(480) 545-7181
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/14/2006
Last updated
07/11/2007
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