Provider Demographics
NPI:1720131824
Name:HITCHCOCK, DONALD NEAL (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:NEAL
Last Name:HITCHCOCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 MOUNT GEORGE AVE
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2131
Mailing Address - Country:US
Mailing Address - Phone:707-224-8586
Mailing Address - Fax:
Practice Address - Street 1:1023 MOUNT GEORGE AVE
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2131
Practice Address - Country:US
Practice Address - Phone:707-224-8586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32516208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
A45178Medicare UPIN