Provider Demographics
NPI:1528154853
Name:HATFIELD, GARY LEE (PA-C)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:LEE
Last Name:HATFIELD
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:18334 GA HWY 85W
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:GA
Mailing Address - Zip Code:31826-0112
Mailing Address - Country:US
Mailing Address - Phone:706-544-9370
Mailing Address - Fax:706-544-9405
Practice Address - Street 1:7950 MARTIN LOOP
Practice Address - Street 2:
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905-5647
Practice Address - Country:US
Practice Address - Phone:706-544-1442
Practice Address - Fax:706-544-1493
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant