Individual
MARK EDWARD HATFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2325 18TH ST STE 130, COLUMBUS, IN 47201-5387
(812) 379-2020
(812) 378-8267
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01036919A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000088174
ANTHEM BCBS
IN
01
—
000000984928
ANTHEM PIN
IN
01
—
011275P
SIHO
IN
01
—
060020869
PALMETTA GBA RAILROAD MC
—
05
—
100343100
—
IN
01
—
64879604
KENTUCKY MEDICAID
KY
Enumeration date
11/07/2006
Last updated
09/06/2024
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