Provider Demographics
NPI:1578188538
Name:HACHIYA, JOEL THOMAS (MD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:THOMAS
Last Name:HACHIYA
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 1:2900 S 70TH ST STE 250
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-3693
Mailing Address - Country:US
Mailing Address - Phone:402-489-4186
Mailing Address - Fax:402-489-5279
Practice Address - Street 1:2900 S 70TH ST STE 250
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-3693
Practice Address - Country:US
Practice Address - Phone:402-489-4186
Practice Address - Fax:402-489-5279
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NE36327207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program