Hattaway, Gary L

Hattaway, Gary L is an individual health care provider with primary practice located at 3708 Northside Dr , Macon GA 31210-2404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Hattaway, Gary L can be contacted via phone (478) 745-4206.

Contact Information

Primary practice address
3708 Northside Dr Macon GA 31210-2404
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 16245 Georgia

Profile Details

NPI number 1225098015
LBN Legal business name Hattaway, Gary L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Feb 27th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225098015 NPPES
Georgia MEDICAID 000144614A
Georgia Other 200009713

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