Provider Demographics
NPI:1750698676
Name:JAMES H. HATTAWAY, D.C. INC
Entity type:Organization
Organization Name:JAMES H. HATTAWAY, D.C. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:HATTAWAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:808-871-6218
Mailing Address - Street 1:95 LONO AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-1610
Mailing Address - Country:US
Mailing Address - Phone:808-871-6218
Mailing Address - Fax:808-871-6253
Practice Address - Street 1:95 LONO AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1610
Practice Address - Country:US
Practice Address - Phone:808-871-6218
Practice Address - Fax:808-871-6253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC 261111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIT41158Medicare UPIN
HIH0000QCBWWMedicare PIN