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Organization
WALTER HATHAWAY, O.D.
Active
Organization
WALTER HATHAWAY, O.D.
Active
Parent organization
WALTER HATHAWAY, O.D.
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALTER HATHAWAY, O.D.
Authorized official
MS. REMONIA R ALDERMAN (OFFICE MANAGER)
(850) 385-0255
Entity
Organization
Contact information
Practice address
255 JOHN KNOX RD, TALLAHASSEE, FL 32303-6676
(850) 385-0255
(850) 385-3941
Mailing address
255 JOHN KNOX RD, TALLAHASSEE, FL 32303-6676
(850) 385-0255
(850) 385-3941
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC860
FL
152WC0802X
Corneal and Contact Management Optometrist
OPC860
FL
152WL0500X
Low Vision Rehabilitation Optometrist
OPC860
FL
152WP0200X
Pediatric Optometrist
OPC860
FL
152WS0006X
Sports Vision Optometrist
OPC860
FL
152WV0400X
Vision Therapy Optometrist
OPC860
FL
152WX0102X
Occupational Vision Optometrist
OPC860
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084900600
—
FL
Enumeration date
04/19/2012
Last updated
04/19/2012
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