Provider Demographics
NPI:1407657497
Name:HATCHETT, SHELBY (DMD)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:HATCHETT
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 BEDFORD FARMS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-6005
Mailing Address - Country:US
Mailing Address - Phone:731-394-4564
Mailing Address - Fax:
Practice Address - Street 1:403 E 11TH ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3409
Practice Address - Country:US
Practice Address - Phone:850-767-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program