Hiatt, Mark D
Hiatt, Mark D is an individual health care provider with primary practice located at 520 Douglas Blvd , Tyler TX 75702-8307. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Hiatt, Mark D can be contacted via phone (903) 510-1175.Contact Information
Primary practice address
520 Douglas Blvd
Tyler TX 75702-8307
Phone: (903) 510-1175
Fax: (903) 510-8806
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | L8075 | Texas |
Profile Details
| NPI number | 1396719597 |
|---|---|
| LBN Legal business name | Hiatt, Mark D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 14th, 2006 |
| Last updated | Mar 29th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396719597 | NPPES |
| Texas | MEDICAID | 175371702 | |
| Texas | MEDICAID | 175371701 |
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