1346234531 NPI number — MR. JAMES EDWARD HATCHER C.R.N.A.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346234531 NPI number — MR. JAMES EDWARD HATCHER C.R.N.A.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

HATCHER

Provider First Name:

JAMES

Provider Middle Name:

EDWARD

Provider Name Prefix Text:

MR.

Provider Name Suffix Text:

Provider Credential Text:

C.R.N.A.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1346234531

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

06/09/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

465 N WILLETT ST

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

MEMPHIS

Provider Business Mailing Address State Name:

TN

Provider Business Mailing Address Postal Code:

38112-5121

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

901-722-5246

Provider Business Mailing Address Fax Number:

901-682-9522

Provider First Line Business Practice Location Address:

1900 EXETER RD

Provider Second Line Business Practice Location Address:

SUITE 210

Provider Business Practice Location Address City Name:

GERMANTOWN

Provider Business Practice Location Address State Name:

TN

Provider Business Practice Location Address Postal Code:

38138-2954

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

901-818-2183

Provider Business Practice Location Address Fax Number:

901-682-9522

Provider Enumeration Date:

09/02/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 367500000X , with the licence number:  APN 9809 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 163W00000X , with the licence number: RN 91970 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 367500000X , with the licence number: C10187 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 367500000X , with the licence number: ARNP9257125 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 154144701 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
• Identifier: 59191503 . This is a "BCBS OF ALABAMA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
• Identifier: G4214 . This is a "BCBS OF FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
• Identifier: 1505216 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
• Identifier: 308254700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
• Identifier: 009941624 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
• Identifier: 3128100 . This is a "BLUE CROSS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
• Identifier: 07089871 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
• Identifier: 5T744 . This is a "BLUE CROSS AR PROV #" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".