Jacob Ryan Hathaway, DO - Camp Lejeune, NC

Jacob Ryan Hathaway, DO

Military Health Care Provider in Camp Lejeune, North Carolina

NPI 1265203277

Jacob Ryan Hathaway is a Military Health Care Provider based in Boise, NC. Jacob Ryan Hathaway practices in Camp Lejeune, NC and has the professional credentials of DO. The NPI Number for Jacob Ryan Hathaway is 1265203277 and holds a License No. (North Carolina).

The current practice location address for Jacob Ryan Hathaway is 100 Brewster Blvd, Camp Lejeune, NC and can be reached out via phone at 910-450-4357.

Location: 100 Brewster Blvd, Camp Lejeune, NC, 83706-6603

NPI Number

1265203277

Provider Name

Jacob Ryan Hathaway

Credential

Provider Entity Type

Individual

Gender

Male

Address

100 Brewster Blvd, Camp Lejeune, NC, 83706-6603

Phone Number

910-450-4357

Fax Number

Provider Enumeration Date

01/10/2024

Last Update Date

03/10/2024

Address

100 Brewster Blvd

City

Camp Lejeune

State

North Carolina

Zip

28547-2575

Phone Number

910-450-4357

Fax Number

Address

100 Brewster Blvd

City

Camp Lejeune

State

North Carolina

Zip

28547-2575

Phone Number

910-450-4357

Fax Number

Type

Other Service Providers

Classification

Military Health Care Provider

Speciality

Taxonomy

171000000X

License No.

()

Definition

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

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