Basic Information
| Provider Information | |||||||||
| NPI: | 1124461306 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HATHAWAY | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | JACKSON | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1215 LEE STREET | ||||||||
| Address2: | PO BOX 800716 | ||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349240211 | ||||||||
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| Practice Location | |||||||||
| Address1: | 361 OLD BELGRADE RD | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | ME | ||||||||
| PostalCode: | 043308058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076216100 | ||||||||
| FaxNumber: | 2076216102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2013 | ||||||||
| LastUpdateDate: | 06/29/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | MD23068 | ME | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.