Basic Information
| Provider Information | |||||||||
| NPI: | 1871533448 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HATCH | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | MONTAGUE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9213 BAYSIDE RD | ||||||||
| Address2: | |||||||||
| City: | FRANKTOWN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 233542216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574140339 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6160 KEMPSVILLE CIR STE 325A | ||||||||
| Address2: | |||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235023933 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7573542885 | ||||||||
| FaxNumber: | 7579175141 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2006 | ||||||||
| LastUpdateDate: | 03/13/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101055294 | VA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QG0300X | 0101055294 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2023462 | 01 | VA | PTAN | OTHER |