Organization
KENNETH J. HATHAWAY DO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH J HATHAWAY D.O. (OWNER)
(401) 783-3334
Entity
Organization
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
—
3623
FEDERAL BLUE CROSS
RI
01
—
3623-2
BLUE CROSS BLUE SHIELD OF RI
RI
05
—
9003623
—
RI
Enumeration date
05/30/2008
Last updated
06/23/2008
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