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NPI Code Detail

MEDICARE: MOLLY MAHON HASTINGS MD

MEDICARE: MOLLY MAHON HASTINGS MD
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
1207W00000XOphthalmology Physician0420009333VT

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 : 1912077520
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY MAHON HASTINGS MD
Provider Business Mailing Address
First Line : 426 INDUSTRIAL AVE
Second Line : STE 132
City : WILLISTON
State : VT
Zip : 05495-4448
Country : US
Telephone Number : 802-497-0916
Fax Number : 802-878-9797
Provider Business Practice Location Address
First Line : 426 INDUSTRIAL AVE
Second Line : STE 132
City : WILLISTON
State : VT
Zip : 05495-4448
Country : US
Telephone Number : 802-497-0916
Fax Number : 802-878-9797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 08/28/2013

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Directions to “ MOLLY MAHON HASTINGS MD” Practice Location

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