Individual
MR. FREDERICK THOMAS HATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6160 TUTT BLVD, SUITE 100, COLORADO SPRINGS, CO 80923-3500
(719) 473-2346
(719) 577-9627
Mailing address
6160 TUTT BLVD, SUITE 100, COLORADO SPRINGS, CO 80923-3500
(719) 473-2346
(719) 577-9627
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2145
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
356676ZGZ2
MEDICARE PTAN
CO
05
—
56975848
—
CO
Enumeration date
06/12/2006
Last updated
04/26/2016
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