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Individual

DR. SCOTT A HATHAWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
309 N BARTLETT ST, SHAWANO, WI 54166-2127
(715) 526-2111
(715) 526-9174
Mailing address
309 N BARTLETT ST, SHAWANO, WI 54166-2127
(715) 526-2111
(715) 526-9174

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
36307
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30064500
WI
Enumeration date
09/27/2006
Last updated
11/02/2012
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