Provider Demographics
NPI:1558732354
Name:HATHAWAY, ALECIA ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALECIA
Middle Name:ANNE
Last Name:HATHAWAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALECIA
Other - Middle Name:
Other - Last Name:ORR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10997 E DISTANT HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262-5210
Mailing Address - Country:US
Mailing Address - Phone:480-939-0125
Mailing Address - Fax:
Practice Address - Street 1:4449 DENVER DRIVE
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:480-939-0125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00498732083P0901X
TXG74162083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine