Individual
JON K HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 274-1661
(317) 278-9918
Mailing address
PO BOX 44730, INDIANAPOLIS, IN 46244-0730
(317) 274-7879
(317) 278-9918
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01061947A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000490913
ANTHEM PTAN
IN
05
—
200830360
—
IN
Enumeration date
06/30/2006
Last updated
09/17/2025
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