Provider Demographics
NPI:1871575803
Name:HATFIELD, PHILIP BRONSON (PHD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:BRONSON
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 VISTA LN
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9067
Mailing Address - Country:US
Mailing Address - Phone:910-992-4362
Mailing Address - Fax:
Practice Address - Street 1:1540 SPRING VALLEY DRIVE
Practice Address - Street 2:HUNTINGTON VETERANS AFFAIRS MEDICAL CENTER
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25704
Practice Address - Country:US
Practice Address - Phone:304-429-6741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3086103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical