Organization
SOUTH MICHIGAN OPHTHALMOLOGY P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARREN PAUL HATHAWAY M.D. (PRESIDENT)
(269) 781-9822
Entity
Organization
Contact information
Practice address
830 W MICHIGAN AVE, MARSHALL, MI 49068-1446
(269) 781-9822
(269) 781-9835
Mailing address
830 W MICHIGAN AVE, MARSHALL, MI 49068-1446
(269) 781-9822
(269) 781-9835
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4301073800
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4421664
—
MI
Enumeration date
08/12/2008
Last updated
08/10/2010
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