Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | DR.0065009 | CO |
Y | 208000000X | Pediatrician | Q0063 | TX |
NPI | 1003221474 |
---|---|
Provider Name | Dr. William Charles Hastings |
First Address | Spearman, TX 79081-3441 |
Second Address | Gunnison, CO 81230-2229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2014 |
Last Update Date | 03/05/2021 |