Provider Demographics
NPI:1124461306
Name:HATHAWAY, LINDSEY JACKSON (MD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JACKSON
Last Name:HATHAWAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 LEE STREET
Mailing Address - Street 2:PO BOX 800716
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908
Mailing Address - Country:US
Mailing Address - Phone:434-924-0211
Mailing Address - Fax:
Practice Address - Street 1:361 OLD BELGRADE RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8058
Practice Address - Country:US
Practice Address - Phone:207-621-6100
Practice Address - Fax:207-621-6102
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2019-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD23068207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology