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General NPI Number Information
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NPI Number | 1861710303
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Entity Type | Organization
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Legal Business Name | JOHN E HATEGAN, M.D. P C
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Dates
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Enumeration Date | 05/07/2010
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Last Update Date | 05/07/2010
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Provider Practice Location Address
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Address Line | 101 CONNIE AVE
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City | SALEM
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State | IN
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Zip | 47167-2305
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Country | US
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Telephone | 812-883-9121
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Fax | 812-883-2161
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Provider Business Mailing Address
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Address Line | 101 CONNIE AVE
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City | SALEM
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State | IN
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Zip | 47167-2305
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Country | US
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Telephone | 812-883-9121
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Fax | 812-883-2161
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN E HATEGAN
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Credential | MD
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Telephone | 812-883-9121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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