Provider Demographics
NPI:1699778944
Name:HATCHER, JASON DANIEL (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:DANIEL
Last Name:HATCHER
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 1:233 N HOUSTON RD
Mailing Address - Street 2:SUITE 140-E
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-3074
Mailing Address - Country:US
Mailing Address - Phone:478-975-6880
Mailing Address - Fax:478-975-6879
Practice Address - Street 1:233 N HOUSTON RD
Practice Address - Street 2:SUITE 140-E
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3074
Practice Address - Country:US
Practice Address - Phone:478-975-6880
Practice Address - Fax:478-975-6879
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2018-11-08
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
GA050635207Q00000X
FLOS8371207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003133193BMedicaid
FL264807500Medicaid
FLOS8371OtherFL LICENSE
FL264807500Medicaid