Individual
DR. CHARLES WALTER HATHAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
255 JOHN KNOX RD, TALLAHASSEE, FL 32303-6676
(850) 385-0255
(850) 385-3941
Mailing address
255 JOHN KNOX RD, TALLAHASSEE, FL 32303-6676
(850) 385-0255
(850) 385-3941
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC860
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084900600
—
FL
Enumeration date
11/28/2006
Last updated
06/28/2024
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