Basic Information
Provider Information
NPI: 1649406380
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HATCHER MARTIN
FirstName: JAIME
MiddleName: MICHELLE
NamePrefix: DR.
NameSuffix:  
Credential: MD, PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HATCHER
OtherFirstName: JAIME
OtherMiddleName: MICHELLE
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: MD, PHD
OtherLastNameType: 1
Mailing Information
Address1: 1841 CLIFTON RD NE
Address2:  
City: ATLANTA
State: GA
PostalCode: 303294021
CountryCode: US
TelephoneNumber: 4047286859
FaxNumber: 4047286685
Practice Location
Address1: 1364 CLIFTON RD NE
Address2:  
City: ATLANTA
State: GA
PostalCode: 303221059
CountryCode: US
TelephoneNumber: 4047275658
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/09/2009
LastUpdateDate: 02/26/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X003935GAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
207R00000X003935GAN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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