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Individual

KEITH MICHAEL HATCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
1978 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 873-1800
Mailing address
185 AUTUMN DR, HOUMA, LA 70360-6099
(985) 226-2773

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA. 200541
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2305468
LA
Enumeration date
07/02/2012
Last updated
09/14/2012
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