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General NPI Number Information
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NPI Number | 1740519693
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Entity Type | Individual
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Provider Name | CATHERINE JO HAUCK PA
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Gender | Female
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Dates
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Enumeration Date | 12/23/2009
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 425 W GRAND AVE STE 2002
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City | DAYTON
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State | OH
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Zip | 45405-4722
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Country | US
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Telephone | 937-294-3611
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Fax |
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Provider Business Mailing Address
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Address Line | 2695 ROCKY MOUNTAIN AVE STE 150
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City | LOVELAND
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State | CO
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Zip | 80538-9071
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Country | US
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Telephone | 970-624-4451
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Fax | 970-490-4199
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 50.005127RX
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 0010-02080
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 50.0051272RX
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License Number State | OH
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