Provider Demographics
NPI:1992812010
Name:HYATT, HUGH CROCKETT (MD)
Entity type:Individual
Prefix:DR
First Name:HUGH
Middle Name:CROCKETT
Last Name:HYATT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-6654
Mailing Address - Country:US
Mailing Address - Phone:865-524-5711
Mailing Address - Fax:
Practice Address - Street 1:631 SCENIC DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-6654
Practice Address - Country:US
Practice Address - Phone:865-524-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2025-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD5995208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3171017Medicaid
TN3171017Medicaid
3171012Medicare PIN