Provider Demographics
NPI:1104826163
Name:HATFIELD, ROBERT W (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:R.
Other - Middle Name:WAYNE
Other - Last Name:HATFIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:828 OLD HICKORY BLVD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4203
Mailing Address - Country:US
Mailing Address - Phone:865-386-5555
Mailing Address - Fax:865-386-5555
Practice Address - Street 1:828 OLD HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4203
Practice Address - Country:US
Practice Address - Phone:865-386-5555
Practice Address - Fax:865-386-5555
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000028878208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNCI2260OtherRAILROAD MEDICARE
TN020252399OtherEEOICP
TN1669416442OtherGROUP NPI
TN4063095OtherBLUE CROSS
TN3106057OtherBLUE CROSS
TN3883459Medicaid
TNH82948Medicare UPIN
TN4063095OtherBLUE CROSS
1260440003Medicare NSC
TN3106057OtherBLUE CROSS
TN3714753Medicare PIN