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General NPI Number Information
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NPI Number | 1548304348
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Entity Type | Individual
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Provider Name | RICHARD A HATHAWAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 9695 S YOSEMITE ST SUITE 200
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City | LONE TREE
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State | CO
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Zip | 80124-2888
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Country | US
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Telephone | 303-338-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 8777 RIDGEPOINT DRIVE
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City | CASTLE PINES
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State | CO
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Zip | 80108
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Country | US
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Telephone | 720-934-5755
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Fax | 303-649-5975
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 31774
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License Number State | CO
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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 | 31774
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License Number State | CO
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