Individual
BOBBY BOYD HATFIELD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, HSPP
Contact information
Practice address
8711 S COUNTY ROAD 600 E, SELMA, IN 47383-9338
(765) 730-2649
Mailing address
8711 S COUNTY ROAD 600 E STE A, SELMA, IN 47383-9338
(765) 730-2649
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
20041571A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000183925
ANTHEM BLUE CROSS BLUE SH
IN
05
—
200271790
—
IN
01
—
2628219000
MAGELLAN
IN
Enumeration date
02/03/2006
Last updated
06/14/2019
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