Doctor Name: | MR. GEORGE WESLEY HATLEY |
NPI Number: | 1184714495 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 102589 |
Business Practice Address: | 3396 Cloverleaf Pkwy Kannapolis, NC - 280836992 |
Business Phone Number: | 7047861776 |
Business Fax Number: | 7047848615 |
Mailing Address: | 30089 Westridge Ct, ALBEMARLE |
State: | NC |
Postal Code: | 280017481 |
Phone Number: | 7049826244 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 102589 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |