NPI 1003643412

Bradley Farel Hathaway

Practitioner Student in an Organized Health Care Education/Training Program Greenville, MS

Practice location

Address: 167 Bayou Rd, Greenville, MS 38701-7732
Phone: (662) 820-3939

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1003643412
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Sep 2024
Record last updated: 18 Sep 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.