MEDICARE: DR. ROBERT A HATHAWAY 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
1	207R00000X	Internal Medicine Physician	3533	MT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110141238	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000018531	OTHER		BCBS MT
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427068295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT A HATHAWAY MD

Provider Business Mailing Address
First Line	:	937 HIGHLAND BLVD
Second Line	:	STE 5410
City	:	BOZEMAN
State	:	MT
Zip	:	59715-6916
Country	:	US
Telephone Number	:	406-414-2400
Fax Number	:

Provider Business Practice Location Address
First Line	:	937 HIGHLAND BLVD STE 5410
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59715-6916
Country	:	US
Telephone Number	:	406-414-2400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	08/05/2021

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Directions to “ DR. ROBERT A HATHAWAY MD” Practice Location

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