Individual
MR. JEFFERY ALLAN HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Mailing address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/04/2011
Last updated
12/11/2014
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