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Individual

DR. LISA A HATCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
265 GRIFFIN ST E, AMERY, WI 54001-1439
(715) 268-8000
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01048925
IN
207Q00000X
Family Medicine Physician
Primary
100422-875
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000325784
ANTHEM
IN
05
200147080
IN
01
3937240025
MEDICARE DMEPOS
IN
Enumeration date
04/18/2006
Last updated
04/17/2023
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