Provider Demographics
NPI:1962981779
Name:HATCHETT, TERRY ALEXANDER III
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:ALEXANDER
Last Name:HATCHETT
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 GOOD HOPE RD SE APT 927
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5142
Mailing Address - Country:US
Mailing Address - Phone:240-708-6857
Mailing Address - Fax:202-750-7387
Practice Address - Street 1:2300 GOOD HOPE RD SE APT 927
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5142
Practice Address - Country:US
Practice Address - Phone:240-708-6857
Practice Address - Fax:202-750-7387
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC30599623747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC3059962OtherSTATE ID