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NPI Code Detail

MEDICARE: JOHN E HATEGAN, M.D. P C

MEDICARE: JOHN E HATEGAN, M.D. P C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861710303
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN E HATEGAN, M.D. P C
Provider Business Mailing Address
First Line : 101 CONNIE AVE
Second Line :
City : SALEM
State : IN
Zip : 47167-2305
Country : US
Telephone Number : 812-883-9121
Fax Number : 812-883-2161
Provider Business Practice Location Address
First Line : 101 CONNIE AVE
Second Line :
City : SALEM
State : IN
Zip : 47167-2305
Country : US
Telephone Number : 812-883-9121
Fax Number : 812-883-2161
Authorized Official
Title or Position : OWNER
Name : DR. JOHN E HATEGAN
Credential : MD
Telephone Number : 812-883-9121
Provider Enumeration Date : 05/07/2010
Last Update Date : 05/07/2010

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