Individual
DR. KELLEY A HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5310 SW 37TH ST, TOPEKA, KS 66614-4540
(785) 267-5010
(785) 267-5010
Mailing address
4132 SE IOWA AVE, TOPEKA, KS 66609-1534
(785) 266-5180
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6492
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116757
BLUE CROSS BLUE SHIELD
KS
Enumeration date
02/27/2007
Last updated
07/08/2007
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