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Individual

JOHN MARK HATHEWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1313 OLENTANGY RIVER RD, COLUMBUS, OH 43212-3120
(614) 890-6555
Mailing address
70 S CLEVELAND AVE STE 100, WESTERVILLE, OH 43081-1397
(614) 890-6555
(614) 461-1730

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35032559
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0305155
OH
01
10792704
CAQH
OH
Enumeration date
10/31/2005
Last updated
03/22/2019
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