Basic Information
Provider Information
NPI: 1659632404
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HATCH
FirstName: MICAH
MiddleName: ALEXANDER
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 110 29TH AVE N STE 202
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372031448
CountryCode: US
TelephoneNumber: 6153274304
FaxNumber: 6153277940
Practice Location
Address1: 110 29TH AVE N STE 202
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372031448
CountryCode: US
TelephoneNumber: 6153274304
FaxNumber: 6153277940
Other Information
ProviderEnumerationDate: 06/07/2012
LastUpdateDate: 03/30/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X51011TNY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home