Provider Demographics
NPI:1386707552
Name:HATTON, ROBERT MALCOLM (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MALCOLM
Last Name:HATTON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2723 WINDEMERE DR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1696
Mailing Address - Country:US
Mailing Address - Phone:229-244-0640
Mailing Address - Fax:229-245-1393
Practice Address - Street 1:2723 WINDEMERE DR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1696
Practice Address - Country:US
Practice Address - Phone:229-244-0640
Practice Address - Fax:229-245-1393
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA15748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist