Provider Demographics
NPI:1104886928
Name:HATTEN, THOMAS JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JAMES
Last Name:HATTEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N. JOHNSON ST.
Mailing Address - Street 2:
Mailing Address - City:COATS
Mailing Address - State:NC
Mailing Address - Zip Code:27521
Mailing Address - Country:US
Mailing Address - Phone:910-897-6423
Mailing Address - Fax:910-897-2540
Practice Address - Street 1:25 NORTH JOHNSON STREET
Practice Address - Street 2:
Practice Address - City:COATS
Practice Address - State:NC
Practice Address - Zip Code:27521
Practice Address - Country:US
Practice Address - Phone:910-897-6423
Practice Address - Fax:910-897-2540
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02613207Q00000X
NC200800345207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5911813Medicaid
NC5911813Medicaid