Provider Demographics
NPI:1770224917
Name:HATTAWAY, REAGAN (MD)
Entity type:Individual
Prefix:DR
First Name:REAGAN
Middle Name:
Last Name:HATTAWAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REAGAN
Other - Middle Name:HATTAWAY
Other - Last Name:FLOWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2212 MORRIS AVE APT 305
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-4245
Mailing Address - Country:US
Mailing Address - Phone:205-399-2803
Mailing Address - Fax:
Practice Address - Street 1:1802 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1932
Practice Address - Country:US
Practice Address - Phone:205-934-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-03
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program