Provider Demographics
NPI:1780568071
Name:HATFIELD, THOMAS JEFFERSON III (CPRS)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JEFFERSON
Last Name:HATFIELD
Suffix:III
Gender:M
Credentials:CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 AMERICANA DR APT 58
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-3120
Mailing Address - Country:US
Mailing Address - Phone:443-286-1251
Mailing Address - Fax:
Practice Address - Street 1:711 BESTGATE RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2453
Practice Address - Country:US
Practice Address - Phone:443-613-8354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPR0667175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist