Provider Demographics
NPI:1316978968
Name:HATFIELD, BRANNAN HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:BRANNAN
Middle Name:HOWARD
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:745 POPLAR ROAD
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-1618
Mailing Address - Country:US
Mailing Address - Phone:770-400-1000
Mailing Address - Fax:404-686-5701
Practice Address - Street 1:745 POPLAR ROAD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:32605-1618
Practice Address - Country:US
Practice Address - Phone:770-400-1000
Practice Address - Fax:404-686-5701
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0410522085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP01060225OtherRAILROAD MEDICARE
GA000868425MMedicaid