Bobby Boyd Hatfield Jr., PHD, HSPP

Individual provider Active NPI Clinical Neuropsychologist · Selma, IN

NPI 1942272992 · NPPES record last updated Jun 14, 2019

Key facts

NPI
1942272992
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Neuropsychologist 103G00000X
License
20041571A (IN)
Practice address
8711 S County Road 600 E
Selma, IN 47383-9338
Phone
(765) 730-2649
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Onhealthcare LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 20041571A IN Yes

Addresses

Primary practice location

8711 S County Road 600 E
Selma, IN 47383-9338

Mailing address

8711 S County Road 600 E Ste a
Selma, IN 47383-9338
Phone (765) 730-2649

Other practice location 1

3645 N Briarwood Ln
Suite A
Muncie, IN 47304-5214
Phone (765) 289-5520

Other practice location 2

3601 W Bethel Ave
Muncie, IN 47304-5408
Phone (765) 282-8222

Other identifiers

IdentifierTypeStateIssuer
2628219000OtherINMAGELLAN
000000183925OtherINANTHEM BLUE CROSS BLUE SH
200271790MedicaidIN

Other providers in Selma, IN

All providers in Selma, IN · Clinical Neuropsychologist in Indiana

Sources for this page

Verify at the official NPI Registry.