Individual
DR. KENNETH J HATHAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
360 KINGSTOWN RD, SUITE 101, NARRAGANSETT, RI 02882-3239
(401) 783-3334
(401) 783-9270
Mailing address
360 KINGSTOWN RD, SUITE 101, NARRAGANSETT, RI 02882-3239
(401) 783-3334
(401) 783-9270
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO278
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050389568
UNITEDHEALTHCARE
RI
01
—
3623
FEDERAL BLUE CROSS
RI
01
—
3623-2
BLUE CROSS OF RHODE ISLAN
RI
05
—
9003623
—
RI
Enumeration date
03/17/2006
Last updated
06/23/2008
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