Individual
DR. JOE NATHAN HACKWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4101 EDWARDS RD, SECOND FLOOR, CINCINNATI, OH 45209-1672
(513) 985-0741
(513) 979-2830
Mailing address
4101 EDWARDS RD, SECOND FLOOR, CINCINNATI, OH 45209-1672
(513) 985-0741
(513) 979-2830
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
33001
KY
207RC0000X
Cardiovascular Disease Physician
35-03-9624
OH
207RI0011X
Interventional Cardiology Physician
35039624
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0317857
—
OH
01
—
0369006
MEDICARE
KY
01
—
0369106
MEDICARE
KY
01
—
0562606
MEDICARE
KY
01
—
060037112
RR MEDICARE
—
01
—
611300608052
CARESOURCE
OH
05
—
64739444
—
KY
01
—
P00884967
RR MEDICARE
OH
Enumeration date
07/01/2005
Last updated
03/24/2023
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