Provider Demographics
NPI:1700515962
Name:HATFIELD, KYLE (DO)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10238 E HAMPTON AVE STE 508
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-3321
Mailing Address - Country:US
Mailing Address - Phone:480-358-6187
Mailing Address - Fax:480-833-8313
Practice Address - Street 1:4545 E SOUTHERN AVE STE 103
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-2677
Practice Address - Country:US
Practice Address - Phone:480-981-6100
Practice Address - Fax:480-981-5501
Is Sole Proprietor?:No
Enumeration Date:2022-06-05
Last Update Date:2024-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ010910207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine