Provider Demographics
NPI:1871533448
Name:HATCH, RICHARD MONTAGUE (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:MONTAGUE
Last Name:HATCH
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 1:9213 BAYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:FRANKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23354-2216
Mailing Address - Country:US
Mailing Address - Phone:757-414-0339
Mailing Address - Fax:
Practice Address - Street 1:6160 KEMPSVILLE CIR STE 325A
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3933
Practice Address - Country:US
Practice Address - Phone:757-354-2885
Practice Address - Fax:757-917-5141
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055294207Q00000X, 207QG0300X
TN41666208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2023462OtherPTAN