Provider Demographics
NPI:1134758766
Name:HAINSWORTH, NATHANIEL CHARLES (DO)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:CHARLES
Last Name:HAINSWORTH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 SHEA CENTER DR STE 450
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2255
Mailing Address - Country:US
Mailing Address - Phone:303-357-2551
Mailing Address - Fax:303-221-2445
Practice Address - Street 1:8200 E BELLEVIEW AVE STE 202C
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2805
Practice Address - Country:US
Practice Address - Phone:303-357-2551
Practice Address - Fax:303-221-2445
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0067207207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program