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General NPI Number Information
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NPI Number | 1053424895
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Entity Type | Individual
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Provider Name | CATHERINE GRACE HAWTHORNE MD
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Gender | Female
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 305 S STRONG DR
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City | GALLUP
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State | NM
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Zip | 87301
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Country | US
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Telephone | 505-726-8015
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Fax |
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Provider Business Mailing Address
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Address Line | 305 S STRONG DR
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City | GALLUP
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State | NM
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Zip | 87301-6162
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Country | US
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Telephone | 505-726-8015
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD8043
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 83-49
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G86219
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License Number State | CA
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